Differentiation of residual/recurrent gliomas from postradiation necrosis with arterial spin labeling and diffusion tensor magnetic resonance imaging-derived metrics

Razek, Ahmed Abdel Khalek Abdel; El-Serougy, Lamiaa; Abdelsalam, Mohamed; Gaballa, Gada; Talaat, Mona

doi:10.1007/s00234-017-1955-3

Cited by 119 publications

(87 citation statements)

References 33 publications

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“…The diagnostic performance of rCBF measured from ASL was found to be comparable to APT imaging in this study. rCBF was observed to be significantly higher in TuR lesions than that in TrE lesions, consistent with previous observations . These findings are not surprising, since tumors and radiation damage have widely different levels of vascularization.…”

Section: Discussionsupporting

confidence: 91%

“…rCBF was observed to be significantly higher in TuR lesions than that in TrE lesions, consistent with previous observations. 24 These findings are not surprising, since tumors and radiation damage have widely different levels of vascularization. In brief, malignant tumors typically possess a high degree of vascular proliferation to supply nutrients for tumor growth.…”

Section: Discussionmentioning

confidence: 98%

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Diagnostic performance of multiparametric MRI in the evaluation of treatment response in glioma patients at 3T

Liu

Chen

et al. 2019

Magnetic Resonance Imaging

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Background MRI is one of the most important techniques to assess the treatment response of gliomas. However, differentiating tumor recurrence (TuR) from treatment effects (TrE) remains challenging. Purpose To compare the diagnostic performance of MR diffusion‐weighted imaging (DWI), arterial spin labeling (ASL), proton MR spectroscopy (MRS), and amide proton transfer (APT) imaging in differentiating between TuR and TrE in posttreatment glioma patients. Study Type Prospective. Population Thirty patients with suspected tumor progression. Field Strength/Sequence DWI, ASL, proton MRS, and APT imaging were performed at 3T MR. Assessment MR indices, including ADC, relative cerebral blood flow (rCBF), ratios of Cho/Cr, Cho/NAA, and NAA/Cr and APT‐weighted (APTw) effect were obtained from DWI, ASL, proton MRS, and APT imaging, respectively. Indices were measured in the contralateral normal‐appearing white matter and lesions defined on the Gd‐enhanced T1w image. TuR or TrE was either determined histologically or clinically from longitudinal MRI follow‐up for at least 6 months. Statistical Tests The diagnostic performance of the indices was evaluated using Student's t‐test, receiver operating characteristic (ROC) curve, and multivariate logistic regression analyses. Results Among the 30 patients, 16 were diagnosed as having TuR and the rest having TrE. The recurrent tumors showed a significantly higher APTw effect (1.56 ± 1.14%) and rCBF (1.44 ± 0.61) compared with lesions representing treatment effects (–0.44 ± 1.34% and 0.72 ± 0.25, respectively, with P < 0.001). The areas under the curve (AUCs) were 0.87 and 0.90 for APTw and rCBF, respectively, in differentiating between TuR and TrE. Combining APTw and rCBF achieved a higher AUC of 0.93. MRS index ratios of Cho/Cr (P = 0.25), Cho/NAA (P = 0.16), and NAA/Cr (P = 0.86) and ADC (P = 0.37) showed no significant differences between TuR and TrE lesions, with AUCs lower than 0.70. Data Conclusion Compared with DWI and MRS, ASL and APT imaging techniques showed better diagnostic capability in distinguishing TuR from TrE. Level of Evidence: 1 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2020;51:1154–1161.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 98%

Diagnostic performance of multiparametric MRI in the evaluation of treatment response in glioma patients at 3T

Liu

Chen

et al. 2019

Magnetic Resonance Imaging

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“…DTI indices are considered non-invasive MR methods for studying the tissue structure. Fractional anisotropy (FA) measures the directionality of diffusion inside tissues while mean diffusivity (MD) is responsible for the estimation of mean diffusivity of water molecules within each voxel [4].…”

Section: Introductionmentioning

confidence: 99%

Diffusion tensor imaging for assessment of normally appearing white matter of the brain and spinal cord in cases of multiple sclerosis: a multi-parametric correlation in view of patient’s clinical status

ElSayed¹,

Eltoukhy

Asaad

et al. 2019

Egypt J Radiol Nucl Med

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Background: Conventional MRI provides important morphologic information regarding the brain and spinal cord involvement by demyelinating plaques. However, it is of almost no value in assessing the normal-appearing white matter which has been proved by multiple pathologic studies to be directly and indirectly involved in the process of multiple sclerosis. Diffusion-weighted imaging and diffusion tensor imaging MRI have been widely used in multiple researches as a better solution for studying the normal-appearing white matter. The purpose of this study was to evaluate the role of diffusion tensor imaging examination of the normal-appearing white matter of the brain and spinal cord in patients with multiple sclerosis and to determine the relationship between diffusion tensor imaging metrics and patient's clinical status. Results: The significant negative correlation found between expanded disability status scale score of secondary progressive MS patients and global (brain and spinal cord) average fractional anisotropy values in normal-appearing white matter and tracts (P = 0.000). Correlation between average apparent diffusion coefficient of corpus callosum tract and expanded disability status scale score revealed a significant positive correlation in RRMS (P = 0.001). While in secondary progressive MS, a significant negative correlation between fractional anisotropy average of the corpus callosum tract and expanded disability status scale score was noted (P = 0.015). Conclusion: There is a strong relationship between diffusion tensor imaging readings and clinical status of patients can be used to understand unexplained deterioration over disease course and also can be used when conventional MRI findings are equivocal. Corpus callosum affection in MS patients is intimately related to clinical status and its assessment should be done whenever possible.

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“…Each response is assigned to a score from zero to three, with the sum of the scores indicating the severity of the symptom with higher scores indicating a more severe depression [18]. For people who have been clinically diagnosed, scores from 0 to 9 represent minimal depressive symptoms, scores from 10 to 16 All images were transferred to a workstation (Philips Extended MR Workspace, 2.6.3.5) for post-processing.…”

Section: Severe or Extreme Depression (Bdi > 30) Requiring Hospitalismentioning

confidence: 99%

“…The FA (fractional anisotropy) detects the directionality of diffusion of water molecules inside the tissue. White matter abnormalities that cause loss of axonal organisation produce lower FA values [16].…”

Section: Introductionmentioning

confidence: 99%

Multiple sclerosis and depressive manifestations: can diffusion tensor MR imaging help in the detection of microstructural white matter changes?

Hassan

Elkholy

Mahmoud

et al. 2019

Egypt J Radiol Nucl Med

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Background: Multiple sclerosis is one of the commonest causes of neurological disability in middle-aged and young adults. Depression in MS patients can compromise cognitive functions, lead to suicide attempts, impair relationships and reduce compliance with disease-modifying treatments. The aim of this study was to investigate and compare the microstructural changes in the white matter tracts of the limbic system in MS patients with and those without depressive manifestations using a diffusion tensor imaging (DTI) technique. Methods: This study included 40 patients who were divided into three groups. Group 1 comprised of 20 patients with relapsing-remitting MS with depressive symptoms and group 2 comprised 10 MS patients without symptoms of depression. The third group is a control group that included 10 age-matched healthy individuals. All patients underwent conventional MRI examinations and DTI to compare the fractional anisotropy (FA) values in the white matter tracts of the limbic system. Results: We compared the DTI findings in MS patients with and those without depressive symptoms. It was found that patients with depression and MS exhibited a significant reduction in the FA values of the cingulum (P < 0.0111 on the right and P < 0.0142 on the left), uncinate fasciculus (P < 0.0001 on the right and P < 0.0076 on the left) and the fornix (P < 0.0001 on both sides). No significant difference was found between the FA values of the anterior thalamic radiations in both groups. Conclusion: Patients with depression and MS showed more pronounced microstructural damage in the major white matter connections of the limbic pathway, namely, the uncinate fasciculus, cingulum and fornix. These changes can be detected by DTI as decreased FA values in depressed MS patients compared to those in non-depressed patients.

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Differentiation of residual/recurrent gliomas from postradiation necrosis with arterial spin labeling and diffusion tensor magnetic resonance imaging-derived metrics

Abstract: Combined ASL and DTI metrics of enhanced lesion and related edema are valuable noninvasive tools in differentiating residual/recurrent gliomas from postradiation changes.

Cited by 119 publications

References 33 publications

Diagnostic performance of multiparametric MRI in the evaluation of treatment response in glioma patients at 3T

Diagnostic performance of multiparametric MRI in the evaluation of treatment response in glioma patients at 3T

Diffusion tensor imaging for assessment of normally appearing white matter of the brain and spinal cord in cases of multiple sclerosis: a multi-parametric correlation in view of patient’s clinical status

Multiple sclerosis and depressive manifestations: can diffusion tensor MR imaging help in the detection of microstructural white matter changes?

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