The role of diffusion and perfusion weighted imaging in the differential diagnosis of cerebral tumors: a review and future perspectives

Abstract

The role of conventional Magnetic Resonance Imaging (MRI) in the detection of cerebral tumors has been well established. However its excellent soft tissue visualization and variety of imaging sequences are in many cases non-specific for the assessment of brain tumor grading. Hence, advanced MRI techniques, like Diffusion-Weighted Imaging (DWI), Diffusion Tensor Imaging (DTI) and Dynamic-Susceptibility Contrast Imaging (DSCI), which are based on different contrast principles, have been used in the clinical routine to improve diagnostic accuracy. The variety of quantitative information derived from these techniques provides significant structural and functional information in a cellular level, highlighting aspects of the underlying brain pathophysiology. The present work, reviews physical principles and recent results obtained using DWI/DTI and DSCI, in tumor characterization and grading of the most common cerebral neoplasms, and discusses how the available MR quantitative data can be utilized through advanced methods of analysis, in order to optimize clinical decision making.

Histogram Analysis of Diffusion Weighted Imaging in Low-Grade Gliomas: in vivo Characterization of Tumor Architecture and Corresponding Neuropathology

“…Magnetic resonance imaging (MRI), offering the highest detail of anatomical as well as functional information in CNS neoplasms has become the gold standard for diagnosis and follow up imaging (8). Among the variety of functional imaging techniques like spin labeling, spectroscopy, perfusion weighted imaging etc., especially diffusion-weighted imaging (DWI) has gained significant importance for assessment of brain tumors (9).…”

Detection of Glioblastoma Subclinical Recurrence Using Serial Diffusion Tensor Imaging

“…In brain tumors, DTI has previously been used to assess WM disruptions to identify tumor grades [13,14], distinguish tumor tissue from peritumoral tissue [15], and study the patterns of shape (isotropic versus anisotropic) in recurrence [16]. Reduced FA has been linked with decreased fiber density index near tumors in patients with GBM [17].…”

Radiomics strategy for glioma grading using texture features from multiparametric MRI

“…8,9 Recently, advanced MRI techniques, including diffusion-weighted imaging (DWI) and arterial spin labeling (ASL) imaging, also showed great potential in glioma grading by noninvasively assessing the cell proliferation and angiogenesis in a heterogeneous microenvironment. [10][11][12][13][14][15] However, most previous studies using these techniques were largely focused on single modality or comparisons among single modality. Simple parameters such as the mean, minimal, or maximal values were commonly used in these studies and could not reflect further phenotype information.…”