Quantitative assessment of invasion of high grade gliomas using diffusion tensor magnetic resonance imaging

Release time:2021-12-25  Hits:

• Impact Factor:2.104
• DOI number:10.1016/j.wneu.2018.02.095
• Journal:World Neurosurgery
• Key Words:Diffusion tensor imaging, High-grade gliomas, Invasive range
• Abstract:High-grade gliomas (HGGs), especially glioblastomas, are the most malignant tumors in the brain, with median survival times of 11e15 months.1 Current standard treatments include resection combined with radiotherapy plus concomitant and adjuvant chemotherapy using temozolomide.2 Microsurgical tumor resection as an initial treatment contributes to prolonged overall survival and is considered the gold standard of treatment whenever safely feasible at the time of initial diagnosis.3 However, owing to the invasive histologic characteristics of this type of tumor, it is difficult to completely remove the tumor. Additionally, brain infiltrated with tumor does not always display enhancements but rather may still appear abnormal on other magnetic resonance imaging (MRI) sequences; thus, the contrast-enhanced tumor volume may underestimate the full extent of the tumor burden.4 Therefore, judgment of the tumor boundary plays a vital role in maximizing the resection. In addition, the influences of increased extents of resection and of reductions in tumor burden on the efficacy of postoperative chemotherapy, radiotherapy, and, ultimately, survival remain inadequately defined. Diffusion tensor imaging (DTI) is widely used in preoperative MRI protocols to visualize white matter tracts for improved surgical planning. In addition to fiber tracking, DTI can be used to assess apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values to characterize tumors and to assess peri tumoral involvement in white matter tracts. In this study, we used advanced MRI techniques to determine the DTI parameters of a region of interest (ROI) within the HGG and in the surrounding affected brain tissue. With the help of navigation, the corre sponding specimens of the ROIs were obtained, pathologic and immunohistochemical tests of the specimens were performed, and the number of tumor cells in each ROI was determined. Based on the differences in the immunohistochemical indices of the ROIs and on the correlation between DTI parameter values and number of tumor cells, we could determine the heterogeneity of a tumor and its surrounding area and explore the scientific judg ment of the HGG invasion range on the basis of the correlation between DTI parameter values and tumor cell numbers.
• Co-author:Xu Cai, Huan Li, Chun Zeng, Jianfeng Wang, Zhixian Gao, Mingyu Zhang, Weibei Dou, Ning Zhang, Jian Xie,Weibei Dou, Mingyu Zhang, Hongyan Chen, Shaowu Li,Mingyu Zhang, Hongyan Chen, Shaowu Li
• First Author:Zonggang Hou,Ruizhi Liao, Mingyu Zhang, Hongyan Chen, Shaowu Li
• Indexed by:Journal paper
• Correspondence Author:Weibei Dou
• Volume:113
• Page Number:561-567
• ISSN No.:1878-8750
• Translation or Not:no
• Date of Publication:2018-05-01