Related Experiment Video
Updated: Aug 6, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Detection of early alterations in radiologically normal-appearing brain regions before recurrence of high-grade
Philipp Raffler1, Severin Schramm1, Cornelius Berberich1
1Department of Neuroradiology, TUM School of Medicine and Health, TUM Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Background:
Quantitative MRI (qMRI) might detect subtle changes in recurrent high-grade glioma earlier than conventional imaging. The purpose of this study was to investigate whether WHO grade 4 glioma patients demonstrate alterations in multiparameter mapping (MPM) and diffusion tensor imaging (DTI)-derived measures within radiologically normal-appearing brain regions that subsequently exhibit tumor recurrence in follow-up scans.
Methods:
For 16 WHO grade 4 glioma patients with confirmed recurrence at follow-up, qMRI parametric maps [proton density (PD), longitudinal relaxation rate (R1), transverse relaxation rate (R2*)] were generated using an MPM protocol. Additionally, diffusion tensor imaging (DTI)-derived free water (FW) and FW-corrected tissue fractional anisotropy (FAt) were evaluated. We mapped recurrent tumor areas onto baseline scans to identify regions that subsequently progressed to contrast-enhancing tumor (CET) or FLAIR-hyperintense areas.
Results:
Normal-appearing gray matter (NAGM) that progressed into FLAIR-hyperintense areas in follow-up scans showed significantly lower median PD values, while median FW was significantly elevated across all subregions compared to their reference regions. This potentially reflects an early redistribution of water from bound tissue compartments into the extracellular space, most evident in gray matter. R1 demonstrated significantly lower median values in NAGM progressing to tumor compared to stable NAGM. Variance was significantly increased for PD, R2*, and FW in multiple subregions, consistent with heterogeneous tumor infiltration.
Conclusions:
MPM and DTI-derived metrics reveal subtle alterations in radiologically normal-appearing brain tissue months before recurrence becomes visible on conventional imaging. This could support earlier identification of subclinical progression and allow for personalized surveillance strategies.
Insights
Quantitative MRI (qMRI) using multiparameter mapping (MPM) and diffusion tensor imaging (DTI) detects subtle brain changes before high-grade glioma recurrence is visible. These advanced MRI techniques show early signs of tumor progression in normal-appearing brain regions.
Area of Science:
- Neuroimaging
- Oncology
- Radiology
Background:
- High-grade glioma recurrence detection often relies on conventional imaging.
- Quantitative MRI (qMRI) offers potential for earlier detection of subtle changes.
Purpose of the Study:
- To investigate alterations in qMRI measures within radiologically normal-appearing brain regions in WHO grade 4 glioma patients.
- To determine if these alterations precede visible tumor recurrence on follow-up scans.
Main Methods:
- 16 WHO grade 4 glioma patients with confirmed recurrence were analyzed.
- Multiparameter mapping (MPM) generated proton density (PD), R1, and R2* maps.
- Diffusion tensor imaging (DTI) derived free water (FW) and fractional anisotropy (FAt).
- Regions progressing to tumor were mapped onto baseline scans.
Main Results:
- Normal-appearing gray matter (NAGM) that later showed tumor progression had significantly lower PD and higher FW.
- R1 values were significantly lower in NAGM progressing to tumor.
- Increased variance in PD, R2*, and FW indicated heterogeneous tumor infiltration.
Conclusions:
- MPM and DTI metrics reveal early, subclinical alterations in brain tissue preceding visible glioma recurrence.
- These findings may enable earlier identification of tumor progression.
- Personalized surveillance strategies for glioma patients could be supported.
