Differentiation of High-Grade Glioma and Intracranial Metastasis Using Volumetric Diffusion Tensor Imaging Tractography

Holly, Kevin S.; Fitz-Gerald, Joseph S.; Barker, Benjamin J.; Murcia, Derrick; Daggett, Rebekah; Ledbetter, Christina; Gonzalez‐Toledo, Eduardo; Sun, Hai

doi:10.1016/j.wneu.2018.07.230

Cited by 10 publications

(9 citation statements)

References 37 publications

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“…However, we excluded the patients with previous metastatic tumor history or high-grade gliomas, and our WM analyses are in line with a study that reported higher MD and lowered FA in the peritumoral region of metastatic tumor patients (Holly et al, 2018). Interestingly, higher FA and lower MD values were observed in the ipsilateral peritumoral regions of glioma patients.…”

Section: White Matter Tract Maturation In the Glioma Migration Processsupporting

confidence: 69%

Glioma Migration Through the Corpus Callosum and the Brainstem Detected by Diffusion and Magnetic Resonance Imaging: Initial Findings

Sharifi

Pajavand

Nateghinia

et al. 2020

Front. Hum. Neurosci.

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Purpose: Glioma cell infiltration, in which the glioma tumor cells spread long distances from the primary location using white matter (WM) or blood vessels, is known as a significant challenge for surgery or localized chemotherapy and radiation therapy. Following the World Health Organization (WHO), the glioma grading system ranges from stages I to IV, in which lower-grade gliomas represent benign tumors, and higher grade gliomas are considered the most malignant. Materials and Methods: We gathered magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) data for seven patients with right precentral gyrus-located tumors and six age-and sex-matched healthy subjects for analysis. Tract-Based Spatial Statistics (TBSS) was utilized to evaluate whole-brain WM implication due to probable tumor infiltration. Also, along-tract statistics were used in order to trace the implicated WM tracts. Finally, for cortical evaluation of probable tumor cell migration, voxel-based morphometry (VBM) was utilized, which allowed us to do whole-brain cortical estimation. Results: The TBSS results revealed significantly higher fractional anisotropy (FA) and lower mean diffusivity (MD) in the left side superior corona radiata. Also, higher FA was observed in the right corticostriatal tract. Along-tract statistics were also compiled on the corpus callosum (CC), which is anatomically known as a hub between hemispheres. The body of the CC, which connected with the superior corona radiata anatomically, showed significantly higher FA values relative to healthy subjects, which are in line with the TBSS results. Consistent with these results, whole-brain gray matter changes were analyzed via VBM, which showed significant hypertrophy of both sides of the brainstem. Conclusion: In future investigations, focusing on the genetic basis of the glioma patients in line with imaging studies on a larger sample size, which is known as genetics imaging, would be a suitable approach for tracing this process.

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Section: White Matter Tract Maturation In the Glioma Migration Processsupporting

confidence: 69%

Glioma Migration Through the Corpus Callosum and the Brainstem Detected by Diffusion and Magnetic Resonance Imaging: Initial Findings

Sharifi

Pajavand

Nateghinia

et al. 2020

Front. Hum. Neurosci.

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“…Studies have characterized the anatomical locations of HGGs to areas with a high ratio of gray and white matter volume, while the LGGs tend to have a preferential bias toward the secondary functional regions of the brain (17,18). Our recent investigation characterized the peritumoral differences in fractional anisotropy (FA) and mean diffusivity (MD) values estimated from diffusion tensor imaging (DTI) in patients with HGGs and IM (19,20). The higher FA and lower MD of HGGs in the peritumoral region were linked to a greater extent of infiltration of glioma upon the surrounding parenchyma (19).…”

Section: Introductionmentioning

confidence: 99%

Biomarkers of Seizure Activity in Patients With Intracranial Metastases and Gliomas: A Wide Range Study of Correlated Regions of Interest

et al. 2020

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Introduction: Studies quantifying cortical metrics in brain tumor patients who present with seizures are limited. The current investigation assesses morphometric/volumetric differences across a wide range of anatomical regions, including temporal and extra-temporal, in patients with gliomas and intracranial metastases (IMs) presenting with seizures that could serve as a biomarker in the identification of seizure expression and serve as a neuronal target for mitigation. Methods: In a retrospective design, the MR sequences of ninety-two tumor patients [55% gliomas; 45% IM] and 34 controls were subjected to sophisticated morphometric and volumetric assessments using BrainSuite and MATLAB modules. We examined 103 regions of interests (ROIs) across eight distinct cortical categories of interests (COI) [gray matter, white matter; total volume, CSF; cortical areas: inner, mid, pial; cortical thickness]. The primary endpoint was quantifying and identifying ROIs with significant differences in z-scores based upon the presence of seizures. Feature selection employing neighborhood component analysis (NCA) determined the ROI within each COI having the highest significance/weight in the differentiation of seizure vs. non-seizure patients harboring brain tumor. Results: Overall, the mean age of the cohort was 58.0 ± 12.8 years, and 45% were women. The prevalence of seizures in tumor patients was 28%. Forty-two ROIs across the eight pre-defined COIs had significant differences in z-scores between tumor patients presenting with and without seizures. The NCA feature selection noted the volume of pars-orbitalis and right middle temporal gyrus to have the highest weight in differentiating tumor patients based on seizures for three distinct COIs [GM, total volume, and CSF volume] and white matter, respectively. Left-sided transverse temporal gyrus, left precuneus, left transverse temporal, and left supramarginal gyrus were associated with having the highest weight in the differentiation of seizure vs. non-seizure in tumor patients for morphometrics relating to cortical areas in the pial, inner and mid regions and cortical thickness, respectively. Kalakoti et al. Biomarkers in Gliomas and Metastasis Conclusion: Our study elucidates potential biomarkers for seizure targeting in patients with gliomas and IMs based upon morphometric and volumetric assessments. Amongst the widespread brain regions examined in our cohort, pars orbitalis, supramarginal and temporal gyrus (middle, transverse), and the pre-cuneus contribute a maximal potential for differentiation of seizure patients from non-seizure.

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“…Based on these findings, multiple studies have used DTI metrics in along-tract and perilesional regions to define brain tumor grade (42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53). Holly et al (20,21) described that FA and MD values were, respectively, higher and lower in perilesional regions of gliomas than in metastases. On the other hand, other studies suggest that FA increases intratumorally in gliomas (20,21,47,(49)(50)(51).…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, although the effectiveness of the AF tractography for guiding pre-and intraoperative resection of tumors in eloquent language areas has already been demonstrated, its ability to determine the biological nature of the tumor or assess its aggressiveness has not been thoroughly investigated (19)(20)(21)(22)(23)(24). Previous studies have highlighted microstructural abnormalities in fascicles localized in proximity to a glioma in or near language or motor cortex (25).…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have highlighted microstructural abnormalities in fascicles localized in proximity to a glioma in or near language or motor cortex (25). However, the absence of a reliable healthy control (HC) population for patient-specificity microstructural comparisons has led to discrepant results (19)(20)(21)(22)(23)(24). Furthermore, to date, the potential role of along-tract analysis has not been tested for language eloquent area gliomas.…”

Section: Introductionmentioning

confidence: 99%

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From Neurosurgical Planning to Histopathological Brain Tumor Characterization: Potentialities of Arcuate Fasciculus Along-Tract Diffusion Tensor Imaging Tractography Measures

et al. 2021

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Background: Tractography has been widely adopted to improve brain gliomas' surgical planning and guide their resection. This study aimed to evaluate state-of-the-art of arcuate fasciculus (AF) tractography for surgical planning and explore the role of along-tract analyses in vivo for characterizing tumor histopathology.Methods: High angular resolution diffusion imaging (HARDI) images were acquired for nine patients with tumors located in or near language areas (age: 41 ± 14 years, mean ± standard deviation; five males) and 32 healthy volunteers (age: 39 ± 16 years; 16 males). Phonemic fluency task fMRI was acquired preoperatively for patients. AF tractography was performed using constrained spherical deconvolution diffusivity modeling and probabilistic fiber tracking. Along-tract analyses were performed, dividing the AF into 15 segments along the length of the tract defined using the Laplacian operator. For each AF segment, diffusion tensor imaging (DTI) measures were compared with those obtained in healthy controls (HCs). The hemispheric laterality index (LI) was calculated from language task fMRI activations in the frontal, parietal, and temporal lobe parcellations. Tumors were grouped into low/high grade (LG/HG).Results: Four tumors were LG gliomas (one dysembryoplastic neuroepithelial tumor and three glioma grade II) and five HG gliomas (two grade III and three grade IV). For LG tumors, gross total removal was achieved in all but one case, for HG in two patients. Tractography identified the AF trajectory in all cases. Four along-tract DTI measures potentially discriminated LG and HG tumor patients (false discovery rate < 0.1): the number of abnormal MD and RD segments, median AD, and MD measures. Both a higher number of abnormal AF segments and a higher AD and MD measures were associated with HG tumor patients. Moreover, correlations (unadjusted p < 0.05) were found between the parietal lobe LI and the DTI measures, which discriminated between LG and HG tumor patients. In particular, a more rightward parietal lobe activation (LI < 0) correlated with a higher number of abnormal MD segments (R = −0.732) and RD segments (R = −0.724).Conclusions: AF tractography allows to detect the course of the tract, favoring the safer-as-possible tumor resection. Our preliminary study shows that along-tract DTI metrics can provide useful information for differentiating LG and HG tumors during pre-surgical tumor characterization.

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Differentiation of High-Grade Glioma and Intracranial Metastasis Using Volumetric Diffusion Tensor Imaging Tractography

Cited by 10 publications

References 37 publications

Glioma Migration Through the Corpus Callosum and the Brainstem Detected by Diffusion and Magnetic Resonance Imaging: Initial Findings

Glioma Migration Through the Corpus Callosum and the Brainstem Detected by Diffusion and Magnetic Resonance Imaging: Initial Findings

Biomarkers of Seizure Activity in Patients With Intracranial Metastases and Gliomas: A Wide Range Study of Correlated Regions of Interest

From Neurosurgical Planning to Histopathological Brain Tumor Characterization: Potentialities of Arcuate Fasciculus Along-Tract Diffusion Tensor Imaging Tractography Measures

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