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Abstract

This study sought to correlate quantitative presurgical proton magnetic resonance spectroscopic imaging (1H-MRSI) and diffusion imaging (DI) results with quantitative histopathological features of resected glioma tissue. The primary hypotheses were (1) glioma choline signal correlates with cell density, (2) glioma apparent diffusion coefficient (ADC) correlates inversely with cell density, (3) glioma choline signal correlates with cell proliferative index. Eighteen adult glioma patients were preoperatively imaged with 1H-MRSI and DI as part of clinically-indicated MRI evaluations. Cell density and proliferative index readings were made on surgical specimens obtained at surgery performed within 12 days of the radiologic scans. The resected tissue location was identified by comparing preoperative and postoperative MRI. The tumor to contralateral normalized choline signal ratio (nCho) and the ADC from resected tumor regions were measured from the preoperative imaging data. Counts of nuclei per high power field in 5-10 fields provided a quantitative measure of cell density. MIB-1 immunohistochemistry provided an index of the proportion of proliferating cells. There was a statistically significant inverse linear correlation between glioma ADC and cell density. There was also a statistically significant linear correlation between the glioma nCho and the cell density. The nCho measure did not significantly correlate with proliferative index. The results indicate that both ADC and spectroscopic choline measures are related to glioma cell density. Therefore they may prove useful for differentiating dense cellular neoplastic lesions from those that contain large proportions of acellular necrotic space.

Quantitative multi-modal MR imaging as a non-invasive prognostic tool for patients with recurrent low-grade glioma

“…The Apparent Diffusion Coefficient (ADC) is used as a measure of cellularity [8–11], and low ADC is associated with shorter progression free and overall survival in LGGs [11–13]. ADC may distinguish between different histological sub-types of LGG [14], and lesions that have transformed to a higher grade and are likely to fail treatment early [15–16]. Fractional Anisotropy (FA) is a measure of the degree of directionality in diffusion [7].…”

Comparison of Turbo Spin Echo and Echo Planar Imaging for intravoxel incoherent motion and diffusion tensor imaging of the kidney at 3 Tesla

“…Diffusion-weighted (DW) MR imaging is able to visualize microscopic features of tissue, such as cellular density [1], tissue anisotropy [2] or even perfusion [3,4]. Anisotropy and the main diffusion direction can be acquired via diffusion tensor imaging (DTI) [2].…”

Nonlinear distortion correction of diffusion MR images improves quantitative DTI measurements in glioblastoma

“…Diffusion tensor imaging (DTI) is a magnetic resonance imaging technique that can be used to probe sub-voxel extracellular microstructure and potentially elicit insight regarding proliferation and infiltration behavior in GBMs. Although controversial, the apparent diffusion coefficient (ADC), a quantity that describes the magnitude of water diffusion, has shown sensitivity to tumor cellularity [4–6], aggressiveness [7, 8], and response to therapies [9, 10]. Fractional anisotropy (FA), a quantitative measure of diffusion anisotropy derived from DTI, has shown sensitivity to tumor infiltration and proliferation [11–14], and is used routinely for preoperative delineation of tumors for resection [15].…”