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Halilibrahimoğlu H, Polat K, Keskin S, Genç O, Aslan O, Öztürk-Işık E, Yakıcıer C, Danyeli AE, Pamir MN, Özduman K, Dinçer A, Özcan A. Associating IDH and TERT Mutations in Glioma with Diffusion Anisotropy in Normal-Appearing White Matter. AJNR Am J Neuroradiol 2023; 44:553-561. [PMID: 37105678 PMCID: PMC10171376 DOI: 10.3174/ajnr.a7855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 03/21/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND AND PURPOSE IDH and TERT mutations might infiltratively manifest within normal-appearing white matter with specific phenotypes such as microstructural changes undetectable by standard MR imaging contrasts but potentially associable with DTI variables. The aim of this retrospective glioma study was to statistically investigate IDH and TERT associations and classifications with DTI reported microstructure in normal-appearing white matter. MATERIALS AND METHODS Retrospective data from patients imaged between March 2012 and February 2016 were analyzed by grouping them as IDH-TERT subgroups and by IDH and TERT mutation status. DTI variables in the IDH-TERT subgroups were first identified by the Kruskal-Wallis test, followed by Dunn-Šidák multiple comparisons with Bonferroni correction. IDH and TERT mutations were compared with the Mann-Whitney U test. Classification by thresholding was tested using receiver operating characteristic analysis. RESULTS Of 170 patients, 70 patients (mean age, 43.73 [SD, 15.32] years; 40 men) were included. Whole-brain normal-appearing white matter fractional anisotropy (FA) and relative anisotropy (RA) (P = .002) were significantly higher and the contralateral-ipsilateral hemispheric differences, ΔFA and ΔRA, (P < .001) were significantly lower in IDHonly patients compared with TERTonly, with a higher whole-brain normal-appearing white matter FA and RA (P = .01) and ΔFA and ΔRA (P = .002) compared to double positive patients. Whole-brain normal-appearing white matter ADC (P = .02), RD (P = .001), λ2 (P = .001), and λ3 (P = .001) were higher in IDH wild-type. Whole-brain normal-appearing white matter λ1 (AD) (P = .003), FA (P < .001), and RA (P = .003) were higher, but Δλ1 (P = .002), ΔFA, and ΔRA (P < .001) were lower in IDH mutant versus IDH wild-type. ΔFA (P = .01) and ΔRA (P = .02) were significantly higher in TERT mutant versus TERT wild-type. CONCLUSIONS Axial and nonaxial diffusivities, anisotropy indices in the normal-appearing white matter and their interhemispheric differences demonstrated microstructural differences between IDH and TERT mutations, with the potential for classification methods.
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Affiliation(s)
- H Halilibrahimoğlu
- Department of Biomedical Engineering (H.H.), McGill University, Montréal, Quebec, Canada
- Biomedical Imaging Research and Development Center (H.H., K.P., S.K., O.A.)
- Institute of Biomedical Engineering (H.H., O.G., E.Ö.-I.), Boğaziçi University Kandilli Campus, Çengelköy, Istanbul, Turkey
| | - K Polat
- From the Department of Electrical and Electronics Engineering (K.P., A.Ö.), Boğaziçi University, Bebek, Istanbul, Turkey
- Biomedical Imaging Research and Development Center (H.H., K.P., S.K., O.A.)
| | - S Keskin
- Biomedical Imaging Research and Development Center (H.H., K.P., S.K., O.A.)
| | - O Genç
- Institute of Biomedical Engineering (H.H., O.G., E.Ö.-I.), Boğaziçi University Kandilli Campus, Çengelköy, Istanbul, Turkey
| | - O Aslan
- Biomedical Imaging Research and Development Center (H.H., K.P., S.K., O.A.)
| | - E Öztürk-Işık
- Brain Tumor Research Group (E.Ö.-I., A.E.D., M.N.P., K.Ö., A.D.)
- Center for Neuroradiological Advanced Research (E.Ö.-I., M.N.P., K.Ö., A.D.), Acibadem Mehmet Ali Aydinlar University, Ataşehir, Istanbul, Turkey
- Institute of Biomedical Engineering (H.H., O.G., E.Ö.-I.), Boğaziçi University Kandilli Campus, Çengelköy, Istanbul, Turkey
| | - C Yakıcıer
- YoctoSensum Biotechnoogy (C.Y.), Fenerbahçe, Istanbul, Turkey
| | - A E Danyeli
- Department of Pathology (A.E.D.)
- Brain Tumor Research Group (E.Ö.-I., A.E.D., M.N.P., K.Ö., A.D.)
| | - M N Pamir
- Department of Neurosurgery (M.N.P., K.Ö.)
- Brain Tumor Research Group (E.Ö.-I., A.E.D., M.N.P., K.Ö., A.D.)
- Center for Neuroradiological Advanced Research (E.Ö.-I., M.N.P., K.Ö., A.D.), Acibadem Mehmet Ali Aydinlar University, Ataşehir, Istanbul, Turkey
| | - K Özduman
- Department of Neurosurgery (M.N.P., K.Ö.)
- Brain Tumor Research Group (E.Ö.-I., A.E.D., M.N.P., K.Ö., A.D.)
- Center for Neuroradiological Advanced Research (E.Ö.-I., M.N.P., K.Ö., A.D.), Acibadem Mehmet Ali Aydinlar University, Ataşehir, Istanbul, Turkey
| | - A Dinçer
- Department of Radiology (A.D.)
- Brain Tumor Research Group (E.Ö.-I., A.E.D., M.N.P., K.Ö., A.D.)
- Center for Neuroradiological Advanced Research (E.Ö.-I., M.N.P., K.Ö., A.D.), Acibadem Mehmet Ali Aydinlar University, Ataşehir, Istanbul, Turkey
| | - A Özcan
- From the Department of Electrical and Electronics Engineering (K.P., A.Ö.), Boğaziçi University, Bebek, Istanbul, Turkey
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Nam KM, Hendriks AD, Boer VO, Klomp DWJ, Wijnen JP, Bhogal AA. Proton metabolic mapping of the brain at 7 T using a two-dimensional free induction decay-echo-planar spectroscopic imaging readout with lipid suppression. NMR Biomed 2022; 35:e4771. [PMID: 35577344 PMCID: PMC9541868 DOI: 10.1002/nbm.4771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 04/14/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
The increased signal-to-noise ratio (SNR) and chemical shift dispersion at high magnetic fields (≥7 T) have enabled neuro-metabolic imaging at high spatial resolutions. To avoid very long acquisition times with conventional magnetic resonance spectroscopic imaging (MRSI) phase-encoding schemes, solutions such as pulse-acquire or free induction decay (FID) sequences with short repetition time and inner volume selection methods with acceleration (echo-planar spectroscopic imaging [EPSI]), have been proposed. With the inner volume selection methods, limited spatial coverage of the brain and long echo times may still impede clinical implementation. FID-MRSI sequences benefit from a short echo time and have a high SNR per time unit; however, contamination from strong extra-cranial lipid signals remains a problem that can hinder correct metabolite quantification. L2-regularization can be applied to remove lipid signals in cases with high spatial resolution and accurate prior knowledge. In this work, we developed an accelerated two-dimensional (2D) FID-MRSI sequence using an echo-planar readout and investigated the performance of lipid suppression by L2-regularization, an external crusher coil, and the combination of these two methods to compare the resulting spectral quality in three subjects. The reduction factor of lipid suppression using the crusher coil alone varies from 2 to 7 in the lipid region of the brain boundary. For the combination of the two methods, the average lipid area inside the brain was reduced by 2% to 38% compared with that of unsuppressed lipids, depending on the subject's region of interest. 2D FID-EPSI with external lipid crushing and L2-regularization provides high in-plane coverage and is suitable for investigating brain metabolite distributions at high fields.
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Affiliation(s)
- Kyung Min Nam
- Center for Image Sciences, Department of RadiologyUniversity Medical Centre UtrechtUtrecht
| | - Arjan D. Hendriks
- Center for Image Sciences, Department of RadiologyUniversity Medical Centre UtrechtUtrecht
| | - Vincent O. Boer
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and ResearchCopenhagen University Hospital HvidovreHvidovreDenmark
| | - Dennis W. J. Klomp
- Center for Image Sciences, Department of RadiologyUniversity Medical Centre UtrechtUtrecht
| | - Jannie P. Wijnen
- Center for Image Sciences, Department of RadiologyUniversity Medical Centre UtrechtUtrecht
| | - Alex A. Bhogal
- Center for Image Sciences, Department of RadiologyUniversity Medical Centre UtrechtUtrecht
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Li X, Abiko K, Sheriff S, Maudsley AA, Urushibata Y, Ahn S, Tha KK. The Distribution of Major Brain Metabolites in Normal Adults: Short Echo Time Whole-Brain MR Spectroscopic Imaging Findings. Metabolites 2022; 12:metabo12060543. [PMID: 35736476 PMCID: PMC9228869 DOI: 10.3390/metabo12060543] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/05/2022] [Accepted: 06/08/2022] [Indexed: 12/10/2022] Open
Abstract
This prospective study aimed to evaluate the variation in magnetic resonance spectroscopic imaging (MRSI)-observed brain metabolite concentrations according to anatomical location, sex, and age, and the relationships among regional metabolite distributions, using short echo time (TE) whole-brain MRSI (WB-MRSI). Thirty-eight healthy participants underwent short TE WB-MRSI. The major metabolite ratios, i.e., N-acetyl aspartate (NAA)/creatine (Cr), choline (Cho)/Cr, glutamate + glutamine (Glx)/Cr, and myoinositol (mI)/Cr, were calculated voxel-by-voxel. Their variations according to anatomical regions, sex, and age, and their relationship to each other were evaluated by using repeated-measures analysis of variance, t-tests, and Pearson’s product-moment correlation analyses. All four metabolite ratios exhibited widespread regional variation across the cerebral hemispheres (corrected p < 0.05). Laterality between the two sides and sex-related variation were also shown (p < 0.05). In several regions, NAA/Cr and Glx/Cr decreased and mI/Cr increased with age (corrected p < 0.05). There was a moderate positive correlation between NAA/Cr and mI/Cr in the insular lobe and thalamus and between Glx/Cr and mI/Cr in the parietal lobe (r ≥ 0.348, corrected p ≤ 0.025). These observations demand age- and sex- specific regional reference values in interpreting these metabolites, and they may facilitate the understanding of glial-neuronal interactions in maintaining homeostasis.
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Affiliation(s)
- Xinnan Li
- Laboratory for Biomarker Imaging Science, Hokkaido University Graduate School of Biomedical Science and Engineering, Sapporo 060-8638, Japan;
| | - Kagari Abiko
- Department of Rehabilitation, Hokkaido University Hospital, Sapporo 060-8648, Japan;
- Department of Rehabilitation, Sapporo Azabu Neurosurgical Hospital, Sapporo 065-0022, Japan
| | - Sulaiman Sheriff
- Department of Radiology, University of Miami School of Medicine, Miami, FL 33146, USA; (S.S.); (A.A.M.)
| | - Andrew A. Maudsley
- Department of Radiology, University of Miami School of Medicine, Miami, FL 33146, USA; (S.S.); (A.A.M.)
| | | | - Sinyeob Ahn
- Siemens Healthineers, San Francisco, CA 94553, USA;
| | - Khin Khin Tha
- Laboratory for Biomarker Imaging Science, Hokkaido University Graduate School of Biomedical Science and Engineering, Sapporo 060-8638, Japan;
- Global Center for Biomedical Science and Engineering, Hokkaido University Faculty of Medicine, Sapporo 060-8638, Japan
- Correspondence: ; Tel.: +81-11-706-8183
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Bogner W, Otazo R, Henning A. Accelerated MR spectroscopic imaging-a review of current and emerging techniques. NMR Biomed 2021; 34:e4314. [PMID: 32399974 PMCID: PMC8244067 DOI: 10.1002/nbm.4314] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/24/2020] [Accepted: 03/30/2020] [Indexed: 05/14/2023]
Abstract
Over more than 30 years in vivo MR spectroscopic imaging (MRSI) has undergone an enormous evolution from theoretical concepts in the early 1980s to the robust imaging technique that it is today. The development of both fast and efficient sampling and reconstruction techniques has played a fundamental role in this process. State-of-the-art MRSI has grown from a slow purely phase-encoded acquisition technique to a method that today combines the benefits of different acceleration techniques. These include shortening of repetition times, spatial-spectral encoding, undersampling of k-space and time domain, and use of spatial-spectral prior knowledge in the reconstruction. In this way in vivo MRSI has considerably advanced in terms of spatial coverage, spatial resolution, acquisition speed, artifact suppression, number of detectable metabolites and quantification precision. Acceleration not only has been the enabling factor in high-resolution whole-brain 1 H-MRSI, but today is also common in non-proton MRSI (31 P, 2 H and 13 C) and applied in many different organs. In this process, MRSI techniques had to constantly adapt, but have also benefitted from the significant increase of magnetic field strength boosting the signal-to-noise ratio along with high gradient fidelity and high-density receive arrays. In combination with recent trends in image reconstruction and much improved computation power, these advances led to a number of novel developments with respect to MRSI acceleration. Today MRSI allows for non-invasive and non-ionizing mapping of the spatial distribution of various metabolites' tissue concentrations in animals or humans, is applied for clinical diagnostics and has been established as an important tool for neuro-scientific and metabolism research. This review highlights the developments of the last five years and puts them into the context of earlier MRSI acceleration techniques. In addition to 1 H-MRSI it also includes other relevant nuclei and is not limited to certain body regions or specific applications.
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Affiliation(s)
- Wolfgang Bogner
- High‐Field MR Center, Department of Biomedical Imaging and Image‐Guided TherapyMedical University of ViennaViennaAustria
| | - Ricardo Otazo
- Department of Medical PhysicsMemorial Sloan Kettering Cancer CenterNew York, New YorkUSA
| | - Anke Henning
- Max Planck Institute for Biological CyberneticsTübingenGermany
- Advanced Imaging Research Center, UT Southwestern Medical CenterDallasTexasUSA
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Maudsley AA, Andronesi OC, Barker PB, Bizzi A, Bogner W, Henning A, Nelson SJ, Posse S, Shungu DC, Soher BJ. Advanced magnetic resonance spectroscopic neuroimaging: Experts' consensus recommendations. NMR Biomed 2021; 34:e4309. [PMID: 32350978 PMCID: PMC7606742 DOI: 10.1002/nbm.4309] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 02/01/2020] [Accepted: 03/10/2020] [Indexed: 05/04/2023]
Abstract
Magnetic resonance spectroscopic imaging (MRSI) offers considerable promise for monitoring metabolic alterations associated with disease or injury; however, to date, these methods have not had a significant impact on clinical care, and their use remains largely confined to the research community and a limited number of clinical sites. The MRSI methods currently implemented on clinical MRI instruments have remained essentially unchanged for two decades, with only incremental improvements in sequence implementation. During this time, a number of technological developments have taken place that have already greatly benefited the quality of MRSI measurements within the research community and which promise to bring advanced MRSI studies to the point where the technique becomes a true imaging modality, while making the traditional review of individual spectra a secondary requirement. Furthermore, the increasing use of biomedical MR spectroscopy studies has indicated clinical areas where advanced MRSI methods can provide valuable information for clinical care. In light of this rapidly changing technological environment and growing understanding of the value of MRSI studies for biomedical studies, this article presents a consensus from a group of experts in the field that reviews the state-of-the-art for clinical proton MRSI studies of the human brain, recommends minimal standards for further development of vendor-provided MRSI implementations, and identifies areas which need further technical development.
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Affiliation(s)
- Andrew A Maudsley
- Department of Radiology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Ovidiu C Andronesi
- Department of Radiology, Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, Massachusetts
| | - Peter B Barker
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, and the Kennedy Krieger Institute, F.M. Kirby Center for Functional Brain Imaging, Baltimore, Maryland
| | - Alberto Bizzi
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Wolfgang Bogner
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria
| | - Anke Henning
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Sarah J Nelson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Stefan Posse
- Department of Neurology, University of New Mexico, Albuquerque, New Mexico
| | - Dikoma C Shungu
- Department of Neuroradiology, Weill Cornell Medical College, New York, New York
| | - Brian J Soher
- Department of Radiology, Duke University Medical Center, Durham, North Carolina
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6
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Goryawala M, Roy B, Gupta RK, Maudsley AA. T1-weighted and T2-weighted Subtraction MR Images for Glioma Visualization and Grading. J Neuroimaging 2020; 31:124-131. [PMID: 33253433 DOI: 10.1111/jon.12800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/14/2020] [Accepted: 09/25/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE To evaluate the performance of multiparametric MR images in differentiation of different regions of the gross tumor area and for assessment of glioma grade. METHODS Forty-six glioma subjects (18 grade II, 11 grade III, and 17 grade IV) underwent a comprehensive MR and spectroscopic imaging procedure. Maps were generated by subtraction of T1-weighted images from contrast-enhanced T1-weighted images (ΔT1 map) and T1-weighted images from T2-weighted images (ΔT2 map). Regions of interest (ROIs) were positioned in normal-appearing white matter (NAWM), enhancing tumor, hyperintense T2, necrotic region, and immediate and distal peritumoral regions (IPR and DPR). Relative signal contrast was estimated as difference between mean intensities in ROIs and NAWM. Classification using support vector machines was applied to all image series to determine the efficacy of regional contrast measures for differentiation of low- and high-grade lesions and grade III and IV lesions. RESULTS ΔT1 and ΔT2 maps offered higher contrast as compared to other parametric maps in differentiating enhancing tumor and edematous regions, respectively, and provided the highest classification accuracy for differentiating low- and high-grade tumors, of 91% and 90.4%. Choline/N-acetylaspartate maps provided significant contrast for delineating IPR and DPR. For differentiating high-grade gliomas, ΔT2 and ΔT1 maps provided a mean accuracy of 90.9% and 88.2%, which was lower than that obtained using cerebral blood volume (93.7%) and choline/creatine (93.3%) maps. CONCLUSION This study showed that subtraction maps provided significant contrast in differentiating several regions of the gross tumor area and are of benefit for accurate tumor grading.
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Affiliation(s)
| | - Bhaswati Roy
- Department of Radiology, Fortis Memorial Research Institute, Gurgaon, India
| | - Rakesh K Gupta
- Department of Radiology, Fortis Memorial Research Institute, Gurgaon, India
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Goryawala M, Saraf-Lavi E, Nagornaya N, Heros D, Komotar R, Maudsley AA. The Association between Whole-Brain MR Spectroscopy and IDH Mutation Status in Gliomas. J Neuroimaging 2019; 30:58-64. [PMID: 31868291 DOI: 10.1111/jon.12685] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/25/2019] [Accepted: 12/13/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND PURPOSE Mutations in isocitrate dehydrogenase (IDH) have a direct effect on gliomagenesis. The purpose of this study is to quantify differences in brain metabolites due to IDH mutations. METHODS Magnetic Resonance Spectroscopic Imaging (MRSI) was performed in 35 patients with gliomas of different grade and varied IDH mutation status. Volumes of interest (VOIs) for active tumor (tVOI), peritumoral area (pVOI), and contralateral normal-appearing white matter (cVOI) were created. Metabolite ratios of Choline (Cho) to both N-acetylaspartate (NAA) and Creatine (Cr) were estimated. Ratios of Glutamate/Glutamine complex (Glx) and myoinositol (mIno) to Cr were also quantified. General linear models (GLMs) were used to estimate the effects of IDH mutation on metabolite measures, with age, gender, and tumor grade used as covariates. RESULTS GLM analysis showed that maximum Cho/NAA and Cho/Cr in the tVOI were significantly (P < .05) higher in IDH mutant lesions as compared to wild-type. In the pVOI, mean Cho/Cr was found to be significantly different among IDH mutant and wild-type gliomas. Mean Cho/NAA (P = .306) and Cho/Cr (P = .292) within the tVOI were not significantly different. Ratios of Glx/Cr and mIno/Cr in any region showed no significant differences between IDH mutant and wild-type gliomas. No significant differences in metabolite ratios were seen in the cVOI between IDH mutants and wild-types. CONCLUSION IDH mutation's effect in gliomas show an increase in Cho in the tumor and perilesional regions as compared to wild-type lesions but do not show widespread changes across the brain.
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Affiliation(s)
| | | | | | - Deborah Heros
- Department of Neurology, University of Miami, Miami, FL
| | - Ricardo Komotar
- Department of Neurological Surgery, University of Miami, Miami, FL
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Yazdani M, Rumboldt Z, Tabesh A, Giglio P, Schiarelli C, Morgan PS, Spampinato MV. Perilesional apparent diffusion coefficient in the preoperative evaluation of glioma grade. Clin Imaging 2018; 52:88-94. [PMID: 30032069 DOI: 10.1016/j.clinimag.2018.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 06/15/2018] [Accepted: 07/04/2018] [Indexed: 01/22/2023]
Abstract
Preoperative identification of high-grade gliomas is critical to optimize treatment strategy and to predict prognosis. To determine whether perilesional apparent diffusion coefficient (ADC) values differ between high- and low-grade tumors, we assessed water diffusivity within normal-appearing brain parenchyma (NABP) surrounding gliomas in twenty-one treatment-naïve patients. This showed significantly lower mean and 25th percentile (Q1) ADC values in high- grade compared to low-grade gliomas respectively in the range of 10-25 and 10-30 mm away from combined tumor and surrounding T2 signal. Thus, perilesional ADC measurement may reflect the extent of tumor infiltration beyond the abnormality seen on conventional MRI.
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Affiliation(s)
- Milad Yazdani
- Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC, USA.
| | - Zoran Rumboldt
- Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC, USA
| | - Ali Tabesh
- Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC, USA
| | - Pierre Giglio
- Department of Neurology, Ohio State University, Wexner Medical College, Columbus, OH, USA
| | - Chiara Schiarelli
- Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC, USA
| | - Paul S Morgan
- Medical Physics & Clinical Engineering, QMC Campus, University of Nottingham, Nottingham, UK
| | - Maria V Spampinato
- Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC, USA
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Goryawala MZ, Heros DO, Komotar RJ, Sheriff S, Saraf-Lavi E, Maudsley AA. Value of diffusion kurtosis imaging in assessing low-grade gliomas. J Magn Reson Imaging 2018; 48:1551-1558. [PMID: 29573042 DOI: 10.1002/jmri.26012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/02/2018] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Diffusion kurtosis imaging (DKI) measures have been shown to provide increased sensitivity relative to diffusion tensor imaging (DTI) in detecting pathologies. PURPOSE To compare the sensitivity of DKI-derived kurtosis and diffusion maps for assessment of low-grade gliomas (LGG). STUDY TYPE Prospective study. POPULATION In all, 19 LGG patients and 26 healthy control subjects were recruited. FIELD STRENGTH/SEQUENCE Echo-planar-imaging diffusion-weighted MR images (b-values = 0, 1000, and 2000 with 30 diffusion gradient directions) were acquired on a 3T scanner. ASSESSMENT Maps for mean, axial, and radial diffusivity (MD, AD, and RD) and kurtosis (MK, AK, and RK), and fractional anisotropy (FA) were evaluated in the tumor, perilesional white matter, and contralateral normal-appearing white matter regions. STATISTICAL TESTING General linear models (GLM), Cohen's d for effect size estimates, false discovery rate (FDR) for multiple corrections, Cochran Q-test. RESULTS Pairwise differences were observed for all diffusion and kurtosis measures between the studied regions (FDR P < 0.001), except an FA map that failed to show significant differences between the lesion and perilesional white matter (FDR P = 0.373). Effect size analysis showed that kurtosis metrics were found to be 18.8% (RK, P = 0.144) to 29.1% (AK, P < 0.05) more sensitive in discriminating perilesional regions from the lesion than corresponding diffusion metrics, whereas AK provided a 25.0% (P < 0.05) increase in sensitivity in discriminating perilesional and contralateral white matter. RK was found to be the most sensitive to contralateral white matter differences between low-grade gliomas and controls, with MK and RK providing a significantly greater sensitivity of 587.2% (P < 0.001) and 320.7% (P < 0.001) than MD and RD, respectively. DATA CONCLUSION Kurtosis maps showed increased sensitivity, as compared to counterpart diffusion maps, for evaluation of microstructural changes in gliomas with a 3-6-fold increment in assessing changes in contralateral white matter. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;48:1551-1558.
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Affiliation(s)
| | - Deborah O Heros
- Department of Neurology, University of Miami, Miami, Florida, USA
| | - Ricardo J Komotar
- Department of Neurological Surgery, University of Miami, Miami, Florida, USA
| | - Sulaiman Sheriff
- Department of Radiology, University of Miami, Miami, Florida, USA
| | - Efrat Saraf-Lavi
- Department of Radiology, University of Miami, Miami, Florida, USA
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Kirov II, Wu WE, Soher BJ, Davitz MS, Huang JH, Babb JS, Lazar M, Fatterpekar G, Gonen O. Global brain metabolic quantification with whole-head proton MRS at 3 T. NMR Biomed 2017; 30:10.1002/nbm.3754. [PMID: 28678429 PMCID: PMC5609859 DOI: 10.1002/nbm.3754] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 05/04/2017] [Accepted: 05/05/2017] [Indexed: 06/07/2023]
Abstract
Total N-acetyl-aspartate + N-acetyl-aspartate-glutamate (NAA), total creatine (Cr) and total choline (Cho) proton MRS (1 H-MRS) signals are often used as surrogate markers in diffuse neurological pathologies, but spatial coverage of this methodology is limited to 1%-65% of the brain. Here we wish to demonstrate that non-localized, whole-head (WH) 1 H-MRS captures just the brain's contribution to the Cho and Cr signals, ignoring all other compartments. Towards this end, 27 young healthy adults (18 men, 9 women), 29.9 ± 8.5 years old, were recruited and underwent T1 -weighted MRI for tissue segmentation, non-localizing, approximately 3 min WH 1 H-MRS (TE /TR /TI = 5/10/940 ms) and 30 min 1 H-MR spectroscopic imaging (MRSI) (TE /TR = 35/2100 ms) in a 360 cm3 volume of interest (VOI) at the brain's center. The VOI absolute NAA, Cr and Cho concentrations, 7.7 ± 0.5, 5.5 ± 0.4 and 1.3 ± 0.2 mM, were all within 10% of the WH: 8.6 ± 1.1, 6.0 ± 1.0 and 1.3 ± 0.2 mM. The mean NAA/Cr and NAA/Cho ratios in the WH were only slightly higher than the "brain-only" VOI: 1.5 versus 1.4 (7%) and 6.6 versus 5.9 (11%); Cho/Cr were not different. The brain/WH volume ratio was 0.31 ± 0.03 (brain ≈ 30% of WH volume). Air-tissue susceptibility-driven local magnetic field changes going from the brain outwards showed sharp gradients of more than 100 Hz/cm (1 ppm/cm), explaining the skull's Cr and Cho signal losses through resonance shifts, line broadening and destructive interference. The similarity of non-localized WH and localized VOI NAA, Cr and Cho concentrations and their ratios suggests that their signals originate predominantly from the brain. Therefore, the fast, comprehensive WH-1 H-MRS method may facilitate quantification of these metabolites, which are common surrogate markers in neurological disorders.
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Affiliation(s)
- Ivan I. Kirov
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - William E. Wu
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - Brian J. Soher
- Department of Radiology, Duke University Medical Center, Durham NC 27710, USA
| | - Matthew S. Davitz
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - Jeffrey H. Huang
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - James S. Babb
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - Mariana Lazar
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - Girish Fatterpekar
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - Oded Gonen
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
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11
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Luo K, Zhuang K. High expression of PCBP2 is associated with progression and poor prognosis in patients with glioblastoma. Biomed Pharmacother 2017; 94:659-65. [PMID: 28787701 DOI: 10.1016/j.biopha.2017.07.103] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/20/2017] [Accepted: 07/20/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Poly(C)-binding protein 2 (PCBP2) has been found to have ambiguous functions in a variety of cancers. However, the specific biological function of PCBP2 and its mechanism in glioblastoma remain unclear. We investigated the expression of PCBP2 in 143 glioblastoma specimens to explore the linkage between PCBP2 expression and clinicopathological parameters as well as clinical significance. Furthermore, the underlying mechanisms of PCBP2 on glioblastoma progression were discussed in vitro. METHODS The transcriptional and translational levels of PCBP2 in 143 glioblastoma patients were detected by quantitative Real-time PCR (qRT-PCR) and western blot. The association of prognostic outcomes and PCBP2 expression was evaluated using Kaplan-Meier analysis. RESULTS PCBP2 expression was markedly increased in higher stages of glioblastoma compared with those in lower stages (P<0.001). High expression of PCBP2 was associated with higher clinical stage and histological grade (P<0.001). Further research suggested that PCBP2 upregulation was connected with poorer prognosis in patients with glioblastoma (P<0.001). Moreover, PCBP2 knockdown could significantly decreased the colony formation and invasion capability of glioblastoma cells (P<0.01). Conversely, PCBP2 overexpression could increase the colony formation and invasion capability (P<0.01). CONCLUSION These findings indicated that PCBP2 might be a novel prognostic biomarker and a potential therapeutic target of glioblastoma.
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12
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Davitz MS, Wu WE, Soher BJ, Babb JS, Kirov II, Huang J, Fatterpekar G, Gonen O. Quantifying global-brain metabolite level changes with whole-head proton MR spectroscopy at 3T. Magn Reson Imaging 2017; 35:15-19. [PMID: 27580518 PMCID: PMC5125897 DOI: 10.1016/j.mri.2016.08.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/21/2016] [Accepted: 08/20/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND AND PURPOSE To assess the sensitivity of non-localized, whole-head 1H-MRS to an individual's serial changes in total-brain NAA, Glx, Cr and Cho concentrations - metabolite metrics often used as surrogate markers in neurological pathologies. MATERIALS AND METHODS In this prospective study, four back-to-back (single imaging session) and three serial (successive sessions) non-localizing, ~3min 1H-MRS (TE/TR/TI=5/104/940ms) scans were performed on 18 healthy young volunteers: 9 women, 9 men: 29.9±7.6 [mean±standard deviation (SD)] years old. These were analyzed by calculating a within-subject coefficient of variation (CV=SD/mean) to assess intra- and inter-scan repeatability and prediction intervals. This study was Health Insurance Portability and Accountability Act compliant. All subjects gave institutional review board-approved written, informed consent. RESULTS The intra-scan CVs for the NAA, Glx, Cr and Cho were: 3.9±1.8%, 7.3±4.6%, 4.0±3.4% and 2.5±1.6%, and the corresponding inter-scan (longitudinal) values were: 7.0±3.1%, 10.6±5.6%, 7.6±3.5% and 7.0±3.9%. This method is shown to have 80% power to detect changes of 14%, 27%, 26% and 19% between two serial measurements in a given individual. CONCLUSIONS Subject to the assumption that in neurological disorders NAA, Glx, Cr and Cho changes represent brain-only pathology and not muscles, bone marrow, adipose tissue or epithelial cells, this approach enables us to quantify them, thereby adding specificity to the assessment of the total disease load. This will facilitate monitoring diffuse pathologies with faster measurement, more extensive (~90% of the brain) spatial coverage and sensitivity than localized 1H-MRS.
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Affiliation(s)
- Matthew S Davitz
- Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - William E Wu
- Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - Brian J Soher
- Department of Radiology, Duke University Medical Center, Durham, NC, 27710, USA
| | - James S Babb
- Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - Ivan I Kirov
- Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - Jeffrey Huang
- Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - Girish Fatterpekar
- Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - Oded Gonen
- Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA.
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13
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Horváth A, Perlaki G, Tóth A, Orsi G, Nagy S, Dóczi T, Horváth Z, Bogner P. Biexponential diffusion alterations in the normal-appearing white matter of glioma patients might indicate the presence of global vasogenic edema. J Magn Reson Imaging 2016; 44:633-41. [PMID: 26914855 DOI: 10.1002/jmri.25202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 02/01/2016] [Accepted: 02/02/2016] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To investigate normal-appearing white matter (NAWM) microstructure of glioma patients with biexponential diffusion analysis in order to reveal the nature of diffusion abnormalities and to assess whether they are region-specific or global. MATERIALS AND METHODS Twenty-four newly diagnosed glioma patients (grade II-IV) and 24 matched control subjects underwent diffusion-weighted imaging at 3T. Diffusion parameters were calculated using monoexponential and biexponential models. Apparent diffusion coefficient (ADC) values were measured in the entire NAWM of the hemisphere contralateral and ipsilateral to the tumor. In the contralateral NAWM, regional ADC values were assessed in the frontal, parietal, occipital, and temporal NAWM. RESULTS ADCmono and ADCfast were significantly higher than control values in all investigated regions except the temporal NAWM (P < 0.04). ADCslow was significantly increased in the total contralateral, frontal, and parietal NAWM (P < 0.03), while pslow was decreased in both total hemispheric NAWM and the parietal NAWM of glioma patients compared to controls (P < 0.04). ADCmono , ADCfast , ADCslow , and pslow were significantly different among the NAWM of the four lobes of the contralateral hemisphere in both groups (P < 0.0001), and these regional differences were similar in patients and controls (P > 0.05). Hemispheric ADCmono and pslow differences were different between groups (P < 0.05). CONCLUSION Globally altered diffusion parameters suggest the presence of global vasogenic edema in the NAWM of glioma patients, which is further supported by the finding that regional differences in patients follow those found in controls. Alternatively, some tumor infiltration might contribute to diffusion abnormalities in the NAWM, especially in the tumor-affected hemisphere. J. Magn. Reson. Imaging 2016;44:633-641.
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Affiliation(s)
- Andrea Horváth
- Diagnostic Center of Pécs, University of Pécs, Pécs, Hungary.,Department of Neurosurgery, University of Pécs, Pécs, Hungary
| | - Gábor Perlaki
- Diagnostic Center of Pécs, University of Pécs, Pécs, Hungary.,MTA - PTE, Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Arnold Tóth
- Diagnostic Center of Pécs, University of Pécs, Pécs, Hungary.,Department of Neurosurgery, University of Pécs, Pécs, Hungary.,Department of Radiology, University of Pécs, Pécs, Hungary
| | - Gergely Orsi
- Diagnostic Center of Pécs, University of Pécs, Pécs, Hungary.,MTA - PTE, Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Szilvia Nagy
- Diagnostic Center of Pécs, University of Pécs, Pécs, Hungary.,MTA - PTE, Neurobiology of Stress Research Group, Pécs, Hungary
| | - Tamás Dóczi
- Department of Neurosurgery, University of Pécs, Pécs, Hungary.,MTA - PTE, Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Zsolt Horváth
- Department of Neurosurgery, University of Pécs, Pécs, Hungary
| | - Péter Bogner
- MTA - PTE, Clinical Neuroscience MR Research Group, Pécs, Hungary
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14
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Price SJ, Young AMH, Scotton WJ, Ching J, Mohsen LA, Boonzaier NR, Lupson VC, Griffiths JR, McLean MA, Larkin TJ. Multimodal MRI can identify perfusion and metabolic changes in the invasive margin of glioblastomas. J Magn Reson Imaging 2016; 43:487-94. [PMID: 26140696 PMCID: PMC5008200 DOI: 10.1002/jmri.24996] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 06/23/2015] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To use perfusion and magnetic resonance (MR) spectroscopy to compare the diffusion tensor imaging (DTI)-defined invasive and noninvasive regions. Invasion of normal brain is a cardinal feature of glioblastomas (GBM) and a major cause of treatment failure. DTI can identify invasive regions. MATERIALS AND METHODS In all, 50 GBM patients were imaged preoperatively at 3T with anatomic sequences, DTI, dynamic susceptibility perfusion MR (DSCI), and multivoxel spectroscopy. The DTI and DSCI data were coregistered to the spectroscopy data and regions of interest (ROIs) were made in the invasive (determined by DTI), noninvasive regions, and normal brain. Values of relative cerebral blood volume (rCBV), N-acetyl aspartate (NAA), myoinositol (mI), total choline (Cho), and glutamate + glutamine (Glx) normalized to creatine (Cr) and Cho/NAA were measured at each ROI. RESULTS Invasive regions showed significant increases in rCBV, suggesting angiogenesis (invasive rCBV 1.64 [95% confidence interval, CI: 1.5-1.76] vs. noninvasive 1.14 [1.09-1.18]; P < 0.001), Cho/Cr (invasive 0.42 [0.38-0.46] vs. noninvasive 0.35 [0.31-0.38]; P = 0.02) and Cho/NAA (invasive 0.54 [0.41-0.68] vs. noninvasive 0.37 [0.29-0.45]; P = < 0.03), suggesting proliferation, and Glx/Cr (invasive 1.54 [1.27-1.82] vs. noninvasive 1.3 [1.13-1.47]; P = 0.028), suggesting glutamate release; and a significantly reduced NAA/Cr (invasive 0.95 [0.85-1.05] vs. noninvasive 1.19 [1.06-1.31]; P = 0.008). The mI/Cr was not different between the three ROIs (invasive 1.2 [0.99-1.41] vs. noninvasive 1.3 [1.14-1.46]; P = 0.68). In the noninvasive regions, the values were not different from normal brain. CONCLUSION Combining DTI to identify the invasive region with perfusion and spectroscopy, we can identify changes in invasive regions not seen in noninvasive regions.
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Affiliation(s)
- Stephen J Price
- Neurosurgery Division, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Adam M H Young
- Neurosurgery Division, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - William J Scotton
- Neurosurgery Division, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Jared Ching
- Neurosurgery Division, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Laila A Mohsen
- University Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Natalie R Boonzaier
- Neurosurgery Division, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Victoria C Lupson
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - John R Griffiths
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, UK
| | - Mary A McLean
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, UK
| | - Timothy J Larkin
- Neurosurgery Division, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
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15
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Horváth A, Perlaki G, Tóth A, Orsi G, Nagy S, Dóczi T, Horváth Z, Bogner P. Increased diffusion in the normal appearing white matter of brain tumor patients: is this just tumor infiltration? J Neurooncol 2015; 127:83-90. [PMID: 26614516 DOI: 10.1007/s11060-015-2011-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 11/22/2015] [Indexed: 10/22/2022]
Abstract
Altered diffusion in the normal appearing white matter (NAWM) of glioma patients has been explained by tumor infiltration. The goal of the present study was to test this explanation indirectly by examining whether these alterations were also present in the contralateral NAWM of non-infiltrative tumors like meningiomas; and to search for other possible reasons for this abnormality. Twenty-seven patients with histologically verified glioma (grade II-IV), 22 meningioma patients and two groups of age- and sex-matched healthy controls underwent diffusion weighted imaging (DWI) on a 3T MR. All patients were examined before treatment. Apparent diffusion coefficient (ADC) values were calculated in the entire NAWM of the hemisphere contralateral to the tumor. ADC values of the NAWM were compared between groups with Mann-Whitney U-test and multiple linear regression. The relations of ADC in NAWM to glioma grade and to tumor volume were also investigated. ADC values of the contralateral NAWM were significantly higher in both glioma and meningioma patients compared to controls (P = 0.0006 and 0.0099, respectively). ADC value was higher in the NAWM of high grade gliomas than in low grade gliomas (P = 0.0181) and in healthy control subjects (P = 0.0003). ADC did not depend on tumor volume in any of the patient groups. Elevated ADC in the NAWM of both glioma and meningioma patients might indicate that the effect of infiltrating tumor cells is not the only reason for the alteration as it has been previously suggested. Although the role of mass effect was not proved, other mechanisms might also contribute to ADC elevation.
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Affiliation(s)
- Andrea Horváth
- Diagnostic Center of Pécs, 2. Rét st., Pécs, 7623, Hungary.,Department of Neurosurgery, University of Pécs, Pécs, Hungary
| | - Gábor Perlaki
- Diagnostic Center of Pécs, 2. Rét st., Pécs, 7623, Hungary.,MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Arnold Tóth
- Diagnostic Center of Pécs, 2. Rét st., Pécs, 7623, Hungary.,Department of Neurosurgery, University of Pécs, Pécs, Hungary.,Department of Radiology, University of Pécs, Pécs, Hungary
| | - Gergely Orsi
- Diagnostic Center of Pécs, 2. Rét st., Pécs, 7623, Hungary.,MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Szilvia Nagy
- Diagnostic Center of Pécs, 2. Rét st., Pécs, 7623, Hungary.,MTA-PTE, Neurobiology of Stress Research Group, Pécs, Hungary
| | - Tamás Dóczi
- Department of Neurosurgery, University of Pécs, Pécs, Hungary.,MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Zsolt Horváth
- Department of Neurosurgery, University of Pécs, Pécs, Hungary
| | - Péter Bogner
- Diagnostic Center of Pécs, 2. Rét st., Pécs, 7623, Hungary. .,Department of Radiology, University of Pécs, Pécs, Hungary.
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Ding XQ, Lanfermann H. Whole Brain 1H-Spectroscopy: A Developing Technique for Advanced Analysis of Cerebral Metabolism. Clin Neuroradiol 2015; 25 Suppl 2:245-50. [DOI: 10.1007/s00062-015-0428-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 06/25/2015] [Indexed: 12/14/2022]
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