Quantitative Diffusion Tensor Imaging Analysis of Low-Grade Gliomas: From Preclinical Application to Patient Care

2017 ◽  
Vol 97 ◽  
pp. 333-343 ◽  
Author(s):  
Tamara Ius ◽  
Luca Turella ◽  
Giada Pauletto ◽  
Miriam Isola ◽  
Marta Maieron ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Patient Care ◽  
Diffusion Tensor ◽  
Low Grade ◽  
Imaging Analysis ◽  
Low Grade Gliomas

Simulation of anisotropic growth of low-grade gliomas using diffusion tensor imaging

2005 ◽  
Vol 54 (3) ◽  
pp. 616-624 ◽  
Author(s):  
Saâd Jbabdi ◽  
Emmanuel Mandonnet ◽  
Hugues Duffau ◽  
Laurent Capelle ◽  
Kristin Rae Swanson ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Diffusion Tensor ◽  
Low Grade ◽  
Anisotropic Growth ◽  
Low Grade Gliomas

CLINICAL EVALUATION AND FOLLOW-UP OUTCOME OF DIFFUSION TENSOR IMAGING-BASED FUNCTIONAL NEURONAVIGATION

Neurosurgery ◽  
2007 ◽  
Vol 61 (5) ◽  
pp. 935-949 ◽  
Author(s):  
Jin-Song Wu ◽  
Liang-Fu Zhou ◽  
Wei-Jun Tang ◽  
Ying Mao ◽  
Jin Hu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Diffusion Tensor Imaging ◽  
Diffusion Tensor ◽  
Three Dimensional ◽  
Low Grade ◽  
Resonance Imaging ◽  
Low Grade Gliomas ◽  
Cerebral Gliomas ◽  
Functional Neuronavigation

Abstract OBJECTIVE To evaluate diffusion tensor imaging (DTI)-based functional neuronavigation in surgery of cerebral gliomas with pyramidal tract (PT) involvement with respect to both perioperative assessment and follow-up outcome. METHODS A prospective, randomized controlled study was conducted between 2001 and 2005. A consecutive series of 238 eligible patients with initial imaging diagnosis of cerebral gliomas involving PTs were randomized into study (n = 118) and control (n = 120) groups. The study cases underwent DTI and three-dimensional magnetic resonance imaging scans. The maps of fractional anisotropy were calculated for PT mapping. Both three-dimensional magnetic resonance imaging data sets and fractional anisotropy maps were integrated by rigid registration, after which the tumor and adjacent PT were segmented and reconstructed for presurgical planning and intraoperative guidance. The control cases were operated on using routine neuronavigation. RESULTS There was a trend for high-grade gliomas (HGGs) in the study group to be more likely to achieve gross total resection (74.4 versus 33.3%, P < 0.001). There was no significant difference of low-grade gliomas resection between the two groups. Postoperative motor deterioration occurred in 32.8% of control cases, whereas it occurred in only 15.3% of the study cases (P < 0.001). The 6-month Karnofsky Performance Scale score of study cases was significantly higher than that of control cases (86 ± 20 versus 74 ± 28 overall, P < 0.001; 93 ± 10 versus 86 ± 17 for low-grade gliomas, P = 0.013; and 77 ± 27 versus 53 ± 32 for HGGs, P = 0.001). For 81 HGGs, the median survival of study cases was 21.2 months (95% confidence interval, 14.1–28.3 mo) compared with 14.0 months (95% confidence interval, 10.2–17.8 mo) of control cases (P = 0.048). The estimated hazard ratio for the effect of DTI-based functional neuronavigation was 0.570, representing a 43.0% reduction in the risk of death. CONCLUSION DTI-based functional neuronavigation contributes to maximal safe resection of cerebral gliomas with PT involvement, thereby decreasing postoperative motor deficits for both HGGs and low-grade gliomas while increasing high-quality survival for HGGs.

scholarly journals Diffusion Tensor Imaging Analysis of Frontal Lobes in Pediatric Traumatic Brain Injury

2010 ◽  
Vol 25 (8) ◽  
pp. 976-984 ◽  
Author(s):  
Margaret B. Oni ◽  
Elisabeth A. Wilde ◽  
Erin D. Bigler ◽  
Stephen R. McCauley ◽  
Trevor C. Wu ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Diffusion Tensor Imaging ◽  
Brain Injury ◽  
Diffusion Tensor ◽  
Frontal Lobes ◽  
Imaging Analysis ◽  
Pediatric Traumatic Brain Injury

scholarly journals Changes in language white matter tract microarchitecture associated with cognitive deficits in patients with presumed low-grade glioma

2019 ◽  
Vol 130 (5) ◽  
pp. 1538-1546 ◽  
Author(s):  
Fatih Incekara ◽  
Djaina Satoer ◽  
Evy Visch-Brink ◽  
Arnaud Vincent ◽  
Marion Smits
Keyword(s):  
Executive Function ◽  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Low Grade Glioma ◽  
Cognitive Domain ◽  
Awake Surgery ◽  
Low Grade ◽  
Linear Regression Models

OBJECTIVEThe authors conducted a study to determine whether cognitive functioning of patients with presumed low-grade glioma is associated with white matter (WM) tract changes.METHODSThe authors included 77 patients with presumed low-grade glioma who underwent awake surgery between 2005 and 2013. Diffusion tensor imaging with deterministic tractography was performed preoperatively to identify the arcuate, inferior frontooccipital, and uncinate fasciculi and to obtain the mean fractional anisotropy (FA) and mean diffusivity per tract. All patients were evaluated preoperatively using an extensive neuropsychological protocol that included assessments of the language, memory, and attention/executive function domains. Linear regression models were used to analyze each cognitive domain and each diffusion tensor imaging metric of the 3 WM tracts.RESULTSSignificant correlations (corrected for multiple testing) were found between FA of the arcuate fasciculus and results of the repetition test for the language domain (β = 0.59, p < 0.0001) and between FA of the inferior frontooccipital fasciculus and results of the imprinting test for the memory domain (β = −0.55, p = 0.002) and the attention test for the attention and executive function domain (β = −0.62, p = 0.006).CONCLUSIONSIn patients with glioma, language deficits in repetition of speech, imprinting, and attention deficits are associated with changes in the microarchitecture of the arcuate and inferior frontooccipital fasciculi.

scholarly journals Assessment of diffusion tensor imaging metrics in differentiating low-grade from high-grade gliomas

2016 ◽  
Vol 29 (5) ◽  
pp. 400-407 ◽  
Author(s):  
Lamiaa El-Serougy ◽  
Ahmed Abdel Khalek Abdel Razek ◽  
Amani Ezzat ◽  
Hany Eldawoody ◽  
Ahmad El-Morsy
Keyword(s):  
Diffusion Tensor Imaging ◽  
Diffusion Tensor ◽  
Low Grade ◽  
High Grade ◽  
High Grade Gliomas

Characterization of abnormal diffusion properties of supratentorial brain tumors: a preliminary diffusion tensor imaging study

2008 ◽  
Vol 1 (4) ◽  
pp. 263-269 ◽  
Author(s):  
Weihong Yuan ◽  
Scott K. Holland ◽  
Blaise V. Jones ◽  
Kerry Crone ◽  
Francesco T. Mangano
Keyword(s):  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Imaging Study ◽  
Low Grade ◽  
High Grade ◽  
The Mean ◽  
Supratentorial Tumors ◽  
Diffusion Properties

Object Diffusion tensor (DT) imaging was used in children with supratentorial tumors to evaluate the anisotropic diffusion properties between different tumor grades and between tumors and adjacent and contralateral white matter. Methods In this retrospective review, the authors review the cases of 16 children (age range 1–18 years) who presented to their institution with supratentorial tumors and were treated between 2004 and 2007. Eleven patients had low-grade and 5 had high-grade tumors. Fractional anisotropy (FA), mean diffusivity, and axial (λ∥) and radial (λ⊥) eigenvalues within selected regions were studied. Mitotic index, necrosis, and vascularity of the tumors were compared with DT imaging parameters. Results The mean diffusivity was significantly higher in low-grade than in high-grade tumors (p = 0.04); the 2 tumor grades also significantly differed for both λ∥ (p < 0.05) and λ⊥ (p < 0.05). Mean diffusivity values in low-grade tumors were significantly higher than in adjacent normal-appearing white matter (NAWM; p = 0.0004) and contralateral NAWM (p = 0.0001). In both low- and high-grade tumors, the FA was significantly lower than in NAWM (p < 0.0001 and p < 0.03, respectively) and contralateral NAWM (p < 0.0001 and p < 0.003, respectively). Tumor cellularity highly correlated with mean diffusivity and λ∥and λ⊥. Conclusions Diffusion tensor imaging is a useful tool in the evaluation of supratentorial tumors in children. The mean diffusivity appears to be a significant marker in differentiating tumors grades. Findings related to λ∥ and λ⊥ within tumor groups and between tumors and NAWM may be an indirect manifestation of the combined effects of axonal injury, demyelination, and tumor mass within the cranial compartment.

Strategies to maximize resection of complex, or high surgical risk, low-grade gliomas

2013 ◽  
Vol 34 (2) ◽  
pp. E5 ◽  
Author(s):  
Jessica A. Wilden ◽  
Jason Voorhies ◽  
Kristine M. Mosier ◽  
Darren P. O'Neill ◽  
Aaron A. Cohen-Gadol
Keyword(s):  
Seizure Control ◽  
Diffusion Tensor ◽  
Brain Mri ◽  
Awake Craniotomy ◽  
Low Grade ◽  
Normal Brain ◽  
Surgical Risk ◽  
Motor Mapping ◽  
Low Grade Gliomas ◽  
High Surgical Risk

Object Early and aggressive resection of low-grade gliomas (LGGs) leads to increased overall patient survival, decreased malignant progression, and better seizure control. This case series describes the authors' approach to achieving optimal neurological and surgical outcomes in patients referred by outside neurosurgeons for stereotactic biopsy of tumors believed to be complex or a high surgical risk, due to their diffuse nature on neuroimaging and their obvious infiltration of functional cortex. Methods Seven patients underwent individualized neuroimaging evaluation preoperatively, which included routine brain MRI with and without contrast administration for intraoperative neuronavigation, functional MRI with speech and motor mapping, diffusion tensor imaging to delineate white matter tracts, and MR perfusion to identify potential foci of higher grade malignancy within the tumor. Awake craniotomy with intraoperative motor and speech mapping was performed in all patients. Tumor removal was initiated through a transsylvian approach for insular lesions, and through multiple corticotomies in stimulation-confirmed noneloquent areas for all other lesions. Resection was continued until neuronavigation indicated normal brain, cortical or subcortical stimulation revealed functional cortex, or the patient began to experience a minor neurological deficit on intraoperative testing. Results Gross-total resection was achieved in 1 patient and subtotal resection (> 80%) in 6 patients, as assessed by postoperative MRI. Over the average follow-up duration of 31 months, no patient experienced a progression or recurrence. Long-term seizure control was excellent in 6 patients who achieved Engel Class I outcomes. Neurologically, all 7 patients experienced mild temporary deficits or seizures that completely resolved, and 1 patient continues to have mild expressive aphasia. Conclusions Significant resection of diffuse, infiltrating LGGs is possible, even in presumed eloquent cortex. Aggressive resection maximizes seizure control and does not necessarily cause permanent neurological deficits. Individualized preoperative neuroimaging evaluation, including tractography and awake craniotomy with intraoperative speech and motor mapping, is an essential tool in achieving these outcomes.

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