Diffusion tensor imaging discriminates between glioblastoma and cerebral metastases in vivo

In a prospective study, patients with a radiologically proven brain tumour underwent diffusion tensor imaging (DTI) prior to definitive diagnosis and treatment. Twenty‐eight patients with a histologically proven glioblastoma or metastasis were included in the study. Following the definition of regions of interest, DTI metrics [mean diffusivity (MD) and fractional anisotropy (FA)] were calculated for the tumour volume and the surrounding region of peritumoral oedema. These metrics were then subjected to logistic regression to investigate their ability to discriminate between glioblastomas and cerebral metastases. A cross‐validation was performed to investigate the ability of the model to predict tumour. The logistic regression analysis correctly distinguished glioblastoma in 15 of 16 cases (93.8%) and metastasis in 11 of 12 cases (91.7%). Cross‐validation resulted in the model correctly predicting 14 of 16 (87.5%) glioblastomas and 10 of 12 (83.3%) metastases studied. MD was significantly higher (p = 0.02) and FA was significantly lower (p = 0.04) within the oedema surrounding metastases than within the oedema around glioblastomas. MD was significantly higher (p = 0.02) within the tumour volume of the glioblastomas. Our results demonstrate that, when DTI metrics from the tumour volume and surrounding peritumoral oedema are studied in combination, glioblastoma can be reliably discriminated from cerebral metastases. Copyright © 2010 John Wiley & Sons, Ltd.

[1]  Sungheon Kim,et al.  Differentiation between glioblastomas and solitary brain metastases using diffusion tensor imaging , 2009, NeuroImage.

[2]  P. Desmond,et al.  Diffusion Tensor Imaging in Glioblastoma Multiforme and Brain Metastases: The Role of p, q, L, and Fractional Anisotropy , 2008, American Journal of Neuroradiology.

[3]  Scott K Holland,et al.  Characterization of abnormal diffusion properties of supratentorial brain tumors: a preliminary diffusion tensor imaging study. , 2008, Journal of neurosurgery. Pediatrics.

[4]  S. Ng,et al.  Primary Cerebral Lymphoma and Glioblastoma Multiforme: Differences in Diffusion Characteristics Evaluated with Diffusion Tensor Imaging , 2008, American Journal of Neuroradiology.

[5]  T. Hirai,et al.  Malignant supratentorial astrocytoma treated with postoperative radiation therapy: prognostic value of pretreatment quantitative diffusion-weighted MR imaging. , 2007, Radiology.

[6]  Ho-Fai Wong,et al.  Peritumoral edema of meningiomas and metastatic brain tumors: differences in diffusion characteristics evaluated with diffusion-tensor MR imaging , 2007, Neuroradiology.

[7]  Paul S Tofts,et al.  Apparent diffusion coefficient histograms may predict low‐grade glioma subtype , 2007, NMR in biomedicine.

[8]  C. Calli,et al.  Perfusion and diffusion MR imaging in enhancing malignant cerebral tumors. , 2006, European journal of radiology.

[9]  W. Hop,et al.  Low-Molecular Weight Caldesmon as a Potential Serum Marker for Glioma , 2005, Clinical Cancer Research.

[10]  Kaoru Kurisu,et al.  Apparent diffusion coefficient of human brain tumors at MR imaging. , 2005, Radiology.

[11]  K Tsuchiya,et al.  Differentiation between solitary brain metastasis and high-grade glioma by diffusion tensor imaging. , 2005, The British journal of radiology.

[12]  Hiroyuki Kabasawa,et al.  Diffusion tensor imaging for preoperative evaluation of tumor grade in gliomas , 2005, Clinical Neurology and Neurosurgery.

[13]  Peter McGraw,et al.  Peritumoral brain regions in gliomas and meningiomas: investigation with isotropic diffusion-weighted MR imaging and diffusion-tensor MR imaging. , 2004, Radiology.

[14]  Yu-Ting Kuo,et al.  Distinction between high-grade gliomas and solitary metastases using peritumoral 3-T magnetic resonance spectroscopy, diffusion, and perfusion imagings , 2004, Neuroradiology.

[15]  Glyn Johnson,et al.  Diffusion-tensor MR imaging of intracranial neoplasia and associated peritumoral edema: introduction of the tumor infiltration index. , 2004, Radiology.

[16]  Hiroyuki Kabasawa,et al.  Measurement of fractional anisotropy using diffusion tensor MRI in supratentorial astrocytic tumors , 2003, Journal of Neuro-Oncology.

[17]  Mark Muzi,et al.  Positron emission tomography imaging of brain tumors. , 2003, Neuroimaging clinics of North America.

[18]  Chris A Clark,et al.  White matter fiber tracking in patients with space-occupying lesions of the brain: a new technique for neurosurgical planning? , 2003, NeuroImage.

[19]  G. Johnson,et al.  Peritumoral diffusion tensor imaging of high-grade gliomas and metastatic brain tumors. , 2003, AJNR. American journal of neuroradiology.

[20]  V. L. Doyle,et al.  Metabolic profiles of human brain tumors using quantitative in vivo 1H magnetic resonance spectroscopy , 2003, Magnetic resonance in medicine.

[21]  Derek K Jones,et al.  Applications of diffusion‐weighted and diffusion tensor MRI to white matter diseases – a review , 2002, NMR in biomedicine.

[22]  Gerhard Schroth,et al.  Use of diffusion-weighted magnetic resonance imaging in differentiating purulent brain processes from cystic brain tumors. , 2002, Journal of neurosurgery.

[23]  James M Provenzale,et al.  Lymphomas and high-grade astrocytomas: comparison of water diffusibility and histologic characteristics. , 2002, Radiology.

[24]  Carl-Fredrik Westin,et al.  Processing and visualization for diffusion tensor MRI , 2002, Medical Image Anal..

[25]  Mark E Bastin,et al.  Diffusion tensor MR imaging of high-grade cerebral gliomas. , 2002, AJNR. American journal of neuroradiology.

[26]  P. Wesseling,et al.  Neuropathological diagnostic accuracy , 2002, British journal of neurosurgery.

[27]  R C McKinstry,et al.  Evaluating pediatric brain tumor cellularity with diffusion-tensor imaging. , 2001, AJR. American journal of roentgenology.

[28]  K. Kono,et al.  The role of diffusion-weighted imaging in patients with brain tumors. , 2001, AJNR. American journal of neuroradiology.

[29]  V. Jellús,et al.  Diffusion-weighted MR imaging of intracerebral masses: comparison with conventional MR imaging and histologic findings. , 2001, AJNR. American journal of neuroradiology.

[30]  R. Wurm,et al.  Comparison of dynamic contrast-enhanced MRI with WHO tumor grading for gliomas , 2001, European Radiology.

[31]  Witham,et al.  Comprehensive assessment of hemorrhage risks and outcomes after stereotactic brain biopsy. , 2001, Journal of neurosurgery.

[32]  J. Klisch,et al.  Supratentorial primitive neuroectodermal tumours: diffusion-weighted MRI , 2000, Neuroradiology.

[33]  K. Okamoto,et al.  Diffusion-weighted echo-planar MR imaging in differential diagnosis of brain tumors and tumor-like conditions , 2000, European Radiology.

[34]  Russell D. Wolfinger,et al.  Multiple Comparisons and Multiple Tests Using the SAS System , 1999 .

[35]  Toshinori Hirai,et al.  Usefulness of diffusion‐weighted MRI with echo‐planar technique in the evaluation of cellularity in gliomas , 1999, Journal of magnetic resonance imaging : JMRI.

[36]  M. Han,et al.  Brain abscess and necrotic or cystic brain tumor: discrimination with signal intensity on diffusion-weighted MR imaging. , 1998, AJR. American journal of roentgenology.

[37]  J C Mazziotta,et al.  Automated image registration: II. Intersubject validation of linear and nonlinear models. , 1998, Journal of computer assisted tomography.

[38]  Scott T. Grafton,et al.  Automated image registration: I. General methods and intrasubject, intramodality validation. , 1998, Journal of computer assisted tomography.

[39]  K. Krabbe,et al.  MR diffusion imaging of human intracranial tumours , 1997, Neuroradiology.

[40]  James R. Moore,et al.  Correction for distortion of echo‐planar images used to calculate the apparent diffusion coefficient , 1996, Magnetic resonance in medicine.

[41]  P. Basser,et al.  Diffusion tensor MR imaging of the human brain. , 1996, Radiology.

[42]  M E Moseley,et al.  Acute and chronic stroke: navigated spin-echo diffusion-weighted MR imaging. , 1996, Radiology.

[43]  P. Basser,et al.  Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI. , 1996, Journal of magnetic resonance. Series B.

[44]  Diffusion and perfusion imaging techniques. , 1995, Magnetic resonance imaging clinics of North America.

[45]  M. Bernstein,et al.  Failed stereotactic biopsy in a series of 518 cases. , 1995, Stereotactic and functional neurosurgery.

[46]  M. Bernstein,et al.  Complications of CT-guided stereotactic biopsy of intra-axial brain lesions. , 1994, Journal of neurosurgery.

[47]  P. Basser,et al.  Estimation of the effective self-diffusion tensor from the NMR spin echo. , 1994, Journal of magnetic resonance. Series B.

[48]  P. Basser,et al.  MR diffusion tensor spectroscopy and imaging. , 1994, Biophysical journal.

[49]  J. Morris,et al.  Greenfield's Neuropathology Edited by J. Hume-Adams and L. W. Ducken. Fifth edition. Oxford University Press, New York (1992), 1557pp. Price £145, U.S.$195 , 1993, Neuroscience.

[50]  Wei Li,et al.  Fast magnetic resonance diffusion‐weighted imaging of acute human stroke , 1992, Neurology.

[51]  M E Moseley,et al.  Diffusion-weighted MR imaging of the brain: value of differentiating between extraaxial cysts and epidermoid tumors. , 1990, AJR. American journal of roentgenology.

[52]  M. Apuzzo,et al.  Computed imaging stereotaxy: experience and perspective related to 500 procedures applied to brain masses. , 1987, Neurosurgery.