A Retrospective Study on Role of DTI in Brain Tumours

Abstract

Brain tumors are a heterogeneous group of benign and malignant tumors. Preoperative radiological assessment is vital in understanding the extent of disease invasion and planning surgical management. This study is to analyze the role of DTI in assessing the different patterns of white matter involvement in patients with brain tumors. Material and methods: A retrospective study was conducted in thirty patients with brain tumours who had undergone both conventional and diffusion tensor imaging. Based on the imaging, the white matter tracts surrounding the tumours were characterized as either displaced or infiltrated. All the medical records of the people diagnosed with brain tumors between February 2018 to February 2019 were reviewed. Results: A total of 30 subjects were included. The proportion of subjects with low grade and high-grade gliomas was 53.3% and 46.7% respectively. Diffusion tensor imaging had shown invasion in 17 (56.7%) of the subjects. Total resection was done in 17 (56.7%) of the subjects and the remaining 13 (43.3%) underwent subtotal resection. The incidence of all the postoperative complications was higher among subjects with invasion shown in DTI, but none of the differences have shown statistically significant differences. Conclusion: Diffusion tensor imaging is a very useful tool in the pre-operative assessment of white matter involvement in cerebral tumors. The people with invasion shown in pre-operative assessment are more likely to have post-operative neurological deficit.

Role of Diffusion Tensor Imaging and Motor Functional MRI in Preoperative Assessment of Brain Tumors

“…We had classified brain tumors in this study into benign and malignant groups, the study included 50 patients 44 of them have malignant lesions (88%) of the cases and 6 have benign lesions (12%) of the cases, we found that there was a statistical difference between the two groups, with prevalence of displacement among the benign group and infiltration and disruption among the malignant group with P value <0.05. This in contrary to the effect of edema where there was no significant difference between the two groups, with P value >0.05. that agreed with study done by G. Karthika [11] who found in their study on 30 patients with brain tumors that high grade gliomas were significantly associated with infiltration of the white matter tracts and with S. Panesar [12 ]who reported in their study that meningiomas, tend to displace white matter rather than specifically damage or destroy it while high-grade gliomas, comprised of aberrant neural tissue, may infiltrate white matter tracts, causing a combination of displacement, disruption, or outright destruction of white matter and we agreed with the result of the study of V. Itagiba [13] who found that the displacement pattern was seen in all the types of tumor. Disruption and infiltration patterns were found in glioblastomas multiforme and anaplastic astrocytomas.…”

“…Three hundred white matter tracts were studied in 50 patients in this study and we found that the most common tract that was affected was the Cortico-Spinal Tract that was affected in 39 cases then Superior Longitudinal Fasiculus that was affected in 38 cases, G. Karthika [11] observed that in their study that the Cortico-Spinal tract was the most common tract to be affected.…”

“…G. Karthika1 [11] reported that MR-tractography provides the neurosurgeon with a new anatomical view that can change the surgical resection planning of a cerebral mass in their study this technique modified the surgical approach to corticotomy in (21%) of cases, permitted the definition of the resection margins in (64%) of cases and resulted in an overall modification of the procedure in 82% of cases. He had reported in his study that DTI is a very important tool for the preoperative planning of surgery.…”