The differences of water diffusion between brain tissue infiltrated by tumor and peritumoral vasogenic edema

Pavliša, Goran; Radoš, Marko; Pavliša, Gordana; Pavić, Luka; Potočki, Kristina; Mayer, Davor

doi:10.1016/j.clinimag.2008.06.035

Cited by 67 publications

(55 citation statements)

References 20 publications

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“…Peritumoral FLAIR and T2 weighted image (T2WI) hyperintensity in GBM patients reflects a mixture of edema and tumor infiltration and is routinely used to evaluate its extent [19], [27], [28], [29]. Thus, these sequences were selected to compute quantitative edema/invasion volumetry.…”

Section: Methodsmentioning

confidence: 99%

Radiogenomic Mapping of Edema/Cellular Invasion MRI-Phenotypes in Glioblastoma Multiforme

et al. 2011

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BackgroundDespite recent discoveries of new molecular targets and pathways, the search for an effective therapy for Glioblastoma Multiforme (GBM) continues. A newly emerged field, radiogenomics, links gene expression profiles with MRI phenotypes. MRI-FLAIR is a noninvasive diagnostic modality and was previously found to correlate with cellular invasion in GBM. Thus, our radiogenomic screen has the potential to reveal novel molecular determinants of invasion. Here, we present the first comprehensive radiogenomic analysis using quantitative MRI volumetrics and large-scale gene- and microRNA expression profiling in GBM.MethodsBased on The Cancer Genome Atlas (TCGA), discovery and validation sets with gene, microRNA, and quantitative MR-imaging data were created. Top concordant genes and microRNAs correlated with high FLAIR volumes from both sets were further characterized by Kaplan Meier survival statistics, microRNA-gene correlation analyses, and GBM molecular subtype-specific distribution.ResultsThe top upregulated gene in both the discovery (4 fold) and validation (11 fold) sets was PERIOSTIN (POSTN). The top downregulated microRNA in both sets was miR-219, which is predicted to bind to POSTN. Kaplan Meier analysis demonstrated that above median expression of POSTN resulted in significantly decreased survival and shorter time to disease progression (P<0.001). High POSTN and low miR-219 expression were significantly associated with the mesenchymal GBM subtype (P<0.0001).ConclusionHere, we propose a novel diagnostic method to screen for molecular cancer subtypes and genomic correlates of cellular invasion. Our findings also have potential therapeutic significance since successful molecular inhibition of invasion will improve therapy and patient survival in GBM.

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Section: Methodsmentioning

confidence: 99%

Radiogenomic Mapping of Edema/Cellular Invasion MRI-Phenotypes in Glioblastoma Multiforme

et al. 2011

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“…This infiltration of peritumoral regions by tumor cells in glioma results in diminished ADC values. Supporting this hypothesis, peritumoral ADC is lower in both anaplastic astrocytoma and glioblastoma compared to metastases (Pavlisa et al, 2009; Han et al, 2014). High b value diffusion imaging (3000 compared to the standard 1000) may slightly improve this approach, as one study found that using a minimum ADC value, the area under the curve (AUC) was 0.92 for b = 3000 compared to 0.89 for b = 1000 (Han et al, 2014).…”

Section: Differentiating Metastases From Similar-appearing Massesmentioning

confidence: 79%

Brain metastases: neuroimaging

Pope

2018

Handbook of Clinical Neurology

149

130

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Magnetic resonance imaging (MRI) is the cornerstone for evaluating patients with brain masses such as primary and metastatic tumors. Important challenges in effectively detecting and diagnosing brain metastases and in accurately characterizing their subsequent response to treatment remain. These difficulties include discriminating metastases from potential mimics such as primary brain tumors and infection, detecting small metastases, and differentiating treatment response from tumor recurrence and progression. Optimal patient management could be benefited by improved and well-validated prognostic and predictive imaging markers, as well as early response markers to identify successful treatment prior to changes in tumor size. To address these fundamental needs, newer MRI techniques including diffusion and perfusion imaging, MR spectroscopy, and positron emission tomography (PET) tracers beyond traditionally used 18-fluorodeoxyglucose are the subject of extensive ongoing investigations, with several promising avenues of added value already identified. These newer techniques provide a wealth of physiologic and metabolic information that may supplement standard MR evaluation, by providing the ability to monitor and characterize cellularity, angiogenesis, perfusion, pH, hypoxia, metabolite concentrations, and other critical features of malignancy. This chapter reviews standard and advanced imaging of brain metastases provided by computed tomography, MRI, and amino acid PET, focusing on potential biomarkers that can serve as problem-solving tools in the clinical management of patients with brain metastases.

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“…A possible explanation for these findings is that because GBMs as well as metastatic lesions show tumor heterogeneities with necrotic and cystic regions, the diffusion of water molecules is facilitated and is considered to be more isotropic in comparison with the diffusion in normal areas. Therefore, inside these lesions the directionality of water diffusion is reduced, a process reflected as a relative decrease in FA values intratumorally compared with the FA values of the contralateral normal side [ 21 , 36–40 ] . Hence it is concluded that ADC and FA values of the intratumoral regions could not serve as predictive indices in the differentiation of these two tumor types, in accordance with previous studies [ 21–25 ] .…”

Section: Discussionmentioning

confidence: 99%

Differentiation of glioblastoma multiforme from metastatic brain tumor using proton magnetic resonance spectroscopy, diffusion and perfusion metrics at 3 T

et al. 2012

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Purpose: To assess the contribution of 1H-magnetic resonance spectroscopy (1H-MRS), diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI) and dynamic susceptibility contrast-enhanced (DSCE) imaging metrics in the differentiation of glioblastomas from solitary metastasis, and particularly to clarify the controversial reports regarding the hypothesis that there should be a significant differentiation between the intratumoral and peritumoral areas. Methods: Conventional MR imaging, 1H-MRS, DWI, DTI and DSCE MRI was performed on 49 patients (35 glioblastomas multiforme, 14 metastases) using a 3.0-T MR unit. Metabolite ratios, apparent diffusion coefficient (ADC), fractional anisotropy (FA) and relative cerebral blood volume (rCBV) were measured in the intratumoral and peritumoral regions of the lesions. Receiver-operating characteristic analysis was used to obtain the cut-off values for the parameters presenting a statistical difference between the two tumor groups. Furthermore, we investigated the potential effect of the region of interest (ROI) size on the quantification of diffusion properties in the intratumoral region of the lesions, by applying two different ROI methods. Results: Peritumoral N-acetylaspartate (NAA)/creatine (Cr), choline (Cho)/Cr, Cho/NAA and rCBV significantly differentiated glioblastomas from intracranial metastases. ADC and FA presented no significant difference between the two tumor groups. Conclusions: 1H-MRS and dynamic susceptibility measurements in the peritumoral regions may definitely aid in the differentiation of glioblastomas and solitary metastases. The quantification of the diffusion properties in the intratumoral region is independent of the ROI size placed.

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The differences of water diffusion between brain tissue infiltrated by tumor and peritumoral vasogenic edema

Cited by 67 publications

References 20 publications

Radiogenomic Mapping of Edema/Cellular Invasion MRI-Phenotypes in Glioblastoma Multiforme

Radiogenomic Mapping of Edema/Cellular Invasion MRI-Phenotypes in Glioblastoma Multiforme

Brain metastases: neuroimaging

Differentiation of glioblastoma multiforme from metastatic brain tumor using proton magnetic resonance spectroscopy, diffusion and perfusion metrics at 3 T

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