Glioma infiltration of the corpus callosum: early signs detected by DTI
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CLINICAL STUDY
Glioma infiltration of the corpus callosum: early signs detected by DTI K. Kallenberg • T. Goldmann • J. Menke • H. Strik • H. C. Bock • F. Stockhammer • J. H. Buhk • J. Frahm • P. Dechent • M. Knauth
Received: 9 October 2012 / Accepted: 1 January 2013 / Published online: 24 January 2013 Ó The Author(s) 2013. This article is published with open access at Springerlink.com
Abstract The most frequent primary brain tumors, anaplastic astrocytomas (AA) and glioblastomas (GBM): tend to invasion of the surrounding brain. Histopathological studies found malignant cells in macroscopically unsuspicious brain parenchyma remote from the primary tumor, even affecting the contralateral hemisphere. In early stages, diffuse interneural infiltration with changes of the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) is suspected. The purpose of this study was to investigate the value of DTI as a possible instrument of depicting K. Kallenberg (&) T. Goldmann M. Knauth Neuroradiology, Universita¨tsmedizin, Georg-August-University Go¨ttingen, Robert-Koch-Str. 40, 37099 Go¨ttingen, Germany e-mail: [email protected] K. Kallenberg T. Goldmann J. H. Buhk P. Dechent MR-Research in Neurology and Psychiatry, Universita¨tsmedizin, Georg-August-University Go¨ttingen, Robert-Koch-Str. 40, 37099 Go¨ttingen, Germany J. Menke Radiology, Universita¨tsmedizin, Georg-August-University Go¨ttingen, Go¨ttingen, Germany
evidence of tumor invasion into the corpus callosum (CC). Preoperatively, 31 patients with high-grade brain tumors (8 AA and 23 GBM) were examined by MRI at 3 T, applying a high-resolution diffusion tensor imaging (DTI) sequence. ADC- and FA-values were analyzed in the tumor-associated area of the CC as identified by fiber tracking, and were compared to matched healthy controls. In (MR-)morphologically normal appearing CC the ADC values were elevated in the tumor patients (n = 22; 0.978 9 10-3 mm2/s) compared to matched controls (0.917 9 10-3 mm2/s, p \ 0.05), and the corresponding relative FA was reduced (rFA: 88 %, p \ 0.01). The effect was pronounced in case of affection of the CC visible on MRI (n = 9; 0.978 9 10-3 mm2/s, p \ 0.05; rFA: 72 % , p \ 0.01). Changes in diffusivity and anisotropy in the CC can be interpreted as an indicator of tumor spread into the contralateral hemisphere not visible on conventional MRI. Keywords Glioma Corpus callosum Magnetic resonance imaging Diffusion tensor imaging
Introduction H. Strik Neurology, University Medical Center, Philipps University Marburg, Marburg, Germany H. C. Bock F. Stockhammer Neurosurgery, Universita¨tsmedizin, Georg-August-University Go¨ttingen, Go¨ttingen, Germany J. H. Buhk Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany J. Frahm Biomedizinische NMR Forschungs GmbH am MPI fu¨r biophysikalische Chemie, Go¨ttingen, Germany
Magnetic resonance imaging (MRI) plays a central role in the staging and treatment of patients with brain tumors. While conventional MRI with T2, FLAIR, and
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