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MR diffusion imaging of human intracranial tumours
1Danish Research Center of Magnetic Resonance, Hvidovre Hospital, Denmark.
Abstract:
We used MRI for in vivo measurement of brain water self-diffusion in patients with intracranial tumours. The study included 28 patients (12 with high-grade and 3 with low-grade gliomas, 7 with metastases, 5 with meningiomas and 1 with a cerebral abscess). Apparent diffusion coefficients (ADC) were calculated in a single axial slice through the tumours, the sequence was sensitive to diffusion along the cephalocaudal axis. Our main finding was that ADC in contrast-enhancing areas within cerebral metastases was statistically significantly higher than ADC in contrast-enhancing areas in high-grade gliomas (P < or = 0.05). Furthermore, the ADC in oedema surrounding metastases were statistically significantly higher the ADC in oedema around high-grade gliomas (P < or = 0.02). The ADC in patients with meningiomas did not differ significantly from those seen with high-grade gliomas or cerebral metastases. The highest ADC were found within cystic or necrotic tumour areas. In one patient with a cerebral abscess, suspected of having a high-grade glioma, the ADC was similar to that in high-grade gliomas. The finding of higher ADC in cerebral metastases than in high-grade gliomas may be helpful in trying to distinguish between these tumours preoperatively; it suggests increased free extracellular and/or intracellular water fraction in cerebral metastases. The method seems to hold potential for further noninvasive characterisation of intracranial tumours.
Insights
Apparent diffusion coefficients (ADC) measured by MRI can help differentiate brain tumors. ADC values were significantly higher in metastases compared to high-grade gliomas, suggesting potential for noninvasive tumor characterization.
Area of Science:
- Neuroimaging
- Radiology
- Oncology
Background:
- Intracranial tumors require accurate preoperative differentiation for optimal treatment.
- Magnetic Resonance Imaging (MRI) offers noninvasive methods for tissue characterization.
Purpose of the Study:
- To investigate the utility of in vivo brain water self-diffusion measurements using MRI for differentiating intracranial tumors.
- To compare Apparent Diffusion Coefficients (ADC) in various tumor types and surrounding edema.
Main Methods:
- MRI scans were performed on 28 patients with intracranial tumors, including gliomas, metastases, meningiomas, and a cerebral abscess.
- Apparent Diffusion Coefficients (ADC) were calculated in contrast-enhancing tumor areas and surrounding edema along the cephalocaudal axis.
Main Results:
- ADC was statistically significantly higher in contrast-enhancing areas of cerebral metastases compared to high-grade gliomas (P <= 0.05).
- ADC was also significantly higher in edema surrounding metastases than around high-grade gliomas (P <= 0.02).
- Highest ADC values were observed in cystic or necrotic tumor regions.
Conclusions:
- Higher ADC in cerebral metastases compared to high-grade gliomas may aid in preoperative tumor differentiation.
- The findings suggest a higher free water fraction in cerebral metastases.
- Diffusion MRI shows potential for noninvasive characterization of intracranial tumors.