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Wang S, Liu C, Rayamajhi AJ, Mao C, Zhang Q. Parasellar epidermoid cyst with unique radiological features: A case report and review of the literature. Radiol Case Rep 2023; 18:1628-1632. [PMID: 36865620 PMCID: PMC9970865 DOI: 10.1016/j.radcr.2023.01.073] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 02/19/2023] Open
Abstract
Intracranial epidermoid cysts (ECs) are encapsulated lesions lined by squamous cell epithelium and the most location is the cerebellopontine angle and appears with cerebrospinal fluid-like irregular mass. Occasionally, ECs present as high-density masses on computed tomography and atypical features in magnetic resonance images in the unusual area, which makes the diagnosis difficult. Here, we report a case of a female subject who complained of episodic left facial convulsions for more than 3 months. Computed tomography plain scan revealed a large hyperdense parasellar mass with atypical magnetic resonance findings. In this report, we analyzed retrospectively the radiological characteristics and histopathology of the parasellar EC, thus increasing awareness about this unusual image features.
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Affiliation(s)
- Sisi Wang
- Department of Radiology, Xi'an Jiaotong University Second Affiliated Hospital, 157 West Fifth Road, Xi'an, Shannxi 710004, China
| | - Chongxiao Liu
- Department of Neurosurgery, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, Shannxi 710004, China
| | - Ashutosh Jung Rayamajhi
- Department of Radiology, Xi'an Jiaotong University Second Affiliated Hospital, 157 West Fifth Road, Xi'an, Shannxi 710004, China
| | - Cuiping Mao
- Department of Radiology, Xi'an Jiaotong University Second Affiliated Hospital, 157 West Fifth Road, Xi'an, Shannxi 710004, China
| | - Qiujuan Zhang
- Department of Radiology, Xi'an Jiaotong University Second Affiliated Hospital, 157 West Fifth Road, Xi'an, Shannxi 710004, China,Corresponding author.
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Gatto RG, Weissmann C, Amin M, Finkielsztein A, Sumagin R, Mareci TH, Uchitel OD, Magin RL. Assessing neuraxial microstructural changes in a transgenic mouse model of early stage Amyotrophic Lateral Sclerosis by ultra-high field MRI and diffusion tensor metrics. Animal Model Exp Med 2020; 3:117-129. [PMID: 32613171 PMCID: PMC7323706 DOI: 10.1002/ame2.12112] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 02/28/2020] [Accepted: 03/22/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Cell structural changes are one of the main features observed during the development of amyotrophic lateral sclerosis (ALS). In this work, we propose the use of diffusion tensor imaging (DTI) metrics to assess specific ultrastructural changes in the central nervous system during the early neurodegenerative stages of ALS. METHODS Ultra-high field MRI and DTI data at 17.6T were obtained from fixed, excised mouse brains, and spinal cords from ALS (G93A-SOD1) mice. RESULTS Changes in fractional anisotropy (FA) and linear, planar, and spherical anisotropy ratios (CL, CP, and CS, respectively) of the diffusion eigenvalues were measured in white matter (WM) and gray matter (GM) areas associated with early axonal degenerative processes (in both the brain and the spinal cord). Specifically, in WM structures (corpus callosum, corticospinal tract, and spinal cord funiculi) as the disease progressed, FA, CL, and CP values decreased, whereas CS values increased. In GM structures (prefrontal cortex, hippocampus, and central spinal cord) FA and CP decreased, whereas the CL and CS values were unchanged or slightly smaller. Histological studies of a fluorescent mice model (YFP, G93A-SOD1 mouse) corroborated the early alterations in neuronal morphology and axonal connectivity measured by DTI. CONCLUSIONS Changes in diffusion tensor shape were observed in this animal model at the early, nonsymptomatic stages of ALS. Further studies of CL, CP, and CS as imaging biomarkers should be undertaken to refine this neuroimaging tool for future clinical use in the detection of the early stages of ALS.
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Affiliation(s)
- Rodolfo G. Gatto
- Department of BioengineeringUniversity of Illinois at ChicagoChicagoILUSA
| | - Carina Weissmann
- Instituto de Fisiología Biologia Molecular y Neurociencias‐IFIBYNE‐CONICETUniversity of Buenos AiresBuenos AiresArgentina
| | - Manish Amin
- Department of BiochemistryNational High Magnetic Field LaboratoryUniversity of FloridaGainesvilleFLUSA
| | - Ariel Finkielsztein
- Department of PathologySchool of MedicineNorthwestern UniversityChicagoILUSA
| | - Ronen Sumagin
- Department of PathologySchool of MedicineNorthwestern UniversityChicagoILUSA
| | - Thomas H. Mareci
- Department of BiochemistryNational High Magnetic Field LaboratoryUniversity of FloridaGainesvilleFLUSA
| | - Osvaldo D. Uchitel
- Instituto de Fisiología Biologia Molecular y Neurociencias‐IFIBYNE‐CONICETUniversity of Buenos AiresBuenos AiresArgentina
| | - Richard L. Magin
- Department of BioengineeringUniversity of Illinois at ChicagoChicagoILUSA
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Balasundaram P, Garg A, Prabhakar A, Joseph Devarajan LS, Gaikwad SB, Khanna G. Evolution of epidermoid cyst into dermoid cyst: Embryological explanation and radiological-pathological correlation. Neuroradiol J 2019; 32:92-97. [PMID: 30604653 DOI: 10.1177/1971400918821086] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Intracranial dermoid and epidermoid cysts are usually considered to be two different entities in the radiological and surgical literature. Epidermoid cysts are classically off midline in location, isointense to cerebrospinal fluid on T1 and T2-weighted images and have restricted diffusion, whereas dermoid cysts are classically midline in location, have T1-hyperintense regions due to the presence of fat and show facilitated diffusion. We report a case of radiological epidermoid cyst in baseline imaging, which evolved into a radiological dermoid cyst over time, and explain this unique occurrence with a review of the embryology and histopathogenesis of these cysts.
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Affiliation(s)
- Parthiban Balasundaram
- 1 Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, India
| | - Ajay Garg
- 1 Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, India
| | - Anuj Prabhakar
- 1 Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, India
| | - Leve S Joseph Devarajan
- 1 Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, India
| | - Shailesh B Gaikwad
- 1 Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, India
| | - Gaurav Khanna
- 2 Department of Pathology, All India Institute of Medical Sciences, India
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Chellathurai A, Muthaiyan P, Gnanasigamani S, Alakappan P. Diffusion tensor imaging metrics in cystic intracranial mass lesions. Indian J Radiol Imaging 2018; 27:457-462. [PMID: 29379242 PMCID: PMC5761174 DOI: 10.4103/ijri.ijri_130_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background and Purpose: Conventional MR does not always differentiate various cystic lesions of brain. Our purpose was to explore the utility of DTI in characterization & differentiation of intra cranial cystic mass lesions. Materials and Methods: DTI was done with a clinical 1.5 Tesla system in 62 patients presenting with intra cranial cystic lesions. Parameter maps of the DTI metrics MD, FA, GA, RA, Geometric tensors (CL,CP,CS) were calculated & quantified using regions of interest. Cystic lesions were grouped based on etiology and management. Statistical analysis was performed to test the significance of difference in DTI metrics in differentiation of various groups of cystic lesions of brain. Results: Mann-Whitney U Test was done to analyse the usefulness of various DTI metrics in differentiating the intracranial cysts. Epidermoid cysts showed highest FA, RA, Cl & Cp due to the preferential diffusion of water through the well structured orientation of keratin filaments & flakes within it. Neurocysticercosis showed higher FA, next to epidermoid. Abscesses showed lowest MD. Arachanoid cyst, giant cistern magna, choroid fissure cyst, choroid plexus cyst, ependymal & neuroglial cysts showed higher MD & lower FA, implicating no preferential directional diffusivity. Conclusion: DTI does prove useful in characterization and differentiation of intracranial cystic mass lesions. This study implicates the need for inclusion of DTI in the routine protocol of imaging cystic intracranial mass lesions.
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Affiliation(s)
- Amarnath Chellathurai
- Department of Radiodiagnosis, Government Stanley Medical College, Chennai, Tamil Nadu, India
| | - Priya Muthaiyan
- Department of Radiodiagnosis, Government Stanley Medical College, Chennai, Tamil Nadu, India
| | - Sathyan Gnanasigamani
- Department of Radiodiagnosis, Government Stanley Medical College, Chennai, Tamil Nadu, India
| | - Periakarupan Alakappan
- Consultant Radiologist, Scansworld Research and Education Institute, Chennai, Tamil Nadu, India
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Andica C, Hori M, Kamiya K, Koshino S, Hagiwara A, Kamagata K, Fukunaga I, Hamasaki N, Suzuki M, Feiweier T, Murata K, Arakawa A, Kondo A, Akiyama O, Aoki S. Spatial Restriction within Intracranial Epidermoid Cysts Observed Using Short Diffusion-time Diffusion-weighted Imaging. Magn Reson Med Sci 2017; 17:269-272. [PMID: 29129844 PMCID: PMC6039784 DOI: 10.2463/mrms.cr.2017-0111] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We report two cases of pathologically proven intracranial epidermoid cysts. Both cases were scanned with diffusion-weighted imaging using pulsed gradient spin-echo (PGSE) and oscillating gradient spin-echo (OGSE; 50 Hz) prototype sequences with diffusion times of 47.3 ms and 8.5 ms, respectively. The apparent diffusion coefficient measured by OGSE was higher than that measured by PGSE, indicating the spatial restriction of water diffusion in the laminated keratin layers within the cyst as demonstrated by histopathology.
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Affiliation(s)
- Christina Andica
- Department of Radiology, Juntendo University Graduate School of Medicine
| | - Masaaki Hori
- Department of Radiology, Juntendo University Graduate School of Medicine
| | - Kouhei Kamiya
- Department of Radiology, Graduate School of Medicine, The University of Tokyo
| | - Saori Koshino
- Department of Radiology, Juntendo University Graduate School of Medicine.,Department of Radiology, Graduate School of Medicine, The University of Tokyo
| | - Akifumi Hagiwara
- Department of Radiology, Juntendo University Graduate School of Medicine.,Department of Radiology, Graduate School of Medicine, The University of Tokyo
| | - Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine
| | - Issei Fukunaga
- Department of Radiology, Juntendo University Graduate School of Medicine
| | - Nozomi Hamasaki
- Department of Radiology, Juntendo University Graduate School of Medicine
| | - Michimasa Suzuki
- Department of Radiology, Juntendo University Graduate School of Medicine
| | | | | | - Atsushi Arakawa
- Department of Human Pathology, Juntendo University School of Medicine
| | - Akihide Kondo
- Department of Neurosurgery, Juntendo University School of Medicine
| | - Osamu Akiyama
- Department of Neurosurgery, Juntendo University School of Medicine
| | - Shigeki Aoki
- Department of Radiology, Juntendo University Graduate School of Medicine
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Zamora C, Castillo M. Sellar and Parasellar Imaging. Neurosurgery 2016; 80:17-38. [DOI: 10.1093/neuros/nyw013] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 10/18/2016] [Indexed: 11/13/2022] Open
Abstract
Abstract
The skull base is a complex anatomical region that harbors many important neurovascular structures in a relatively confined space. The pathology that can develop at this site is varied, and many disease processes may present with similar clinical and neuroimaging findings. While computed tomography maintains a role in the evaluation of many entities and can, for instance, delineate osseous erosion with great detail and characterize calcified tumor matrices, magnetic resonance imaging (MRI) is the mainstay in the neuroimaging assessment of most pathology occurring at the skull base. Various MRI sequences have proven to be robust tools for tissue characterization and can provide information on the presence of lipids, paramagnetic and diamagnetic elements, and tumor cellularity, among others. In addition, currently available MRI techniques are able to generate high spatial resolution images that allow visualization of cranial nerves and their involvement by adjacent pathology. The information obtained from such examinations may aid in the distinction of these disease processes and in the accurate delineation of their extent prior to biopsy or treatment planning.
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Srinivasan K, Thomas B, Shah D, Kannath SK, Menon G, Sandhyamani S, Kesavadas C, Kapilamoorthy TR. Quantification of diffusion and anisotropy in intracranial epidermoids using diffusion tensor metrics and p: q tensor decomposition. J Neuroradiol 2016; 43:363-370. [PMID: 27318387 DOI: 10.1016/j.neurad.2016.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 02/22/2016] [Accepted: 02/24/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To quantitatively evaluate the diffusion tensor metrics p, q, L and fractional anisotropy in intracranial epidermoids in comparison with normal white matter in the splenium of the corpus callosum. METHODS This retrospective study included 20 consecutive patients referred to our institute. All patients had a magnetic resonance imaging (MRI) study on a 1.5-Tesla MR system. A spin-echo echo-planar DTI sequence with diffusion gradients along 30 non-collinear directions was performed. The eigen values (λ1, λ2, λ3) were computed for each voxel and, using p: q tensor decomposition, the DTI metrics p, q and L-values and fractional anositropy (FA) were calculated. The region of interest (ROI) (6 pixels each) was placed within the lesion in all the cases and in the splenium of the corpus callosum. RESULTS The mean FA in the lesion and splenium were 0.50 and 0.88 respectively, with a statistically significant difference between them (P<0.01). On p: q tensor decomposition, the mean p-value in the epidermoid was 1.55±0.24 and 1.35±0.20 in the splenium; the mean q-values in the epidermoid was 0.67±0.13 and 1.27±0.17 in the splenium; the differences were statistically significant (P=0.01 and <0.01 respectively). The significant difference between p- and q-values in epidermoids compared with the splenium of callosum was probably due to structural and orientation differences in the keratin flakes in epidermoids and white matter bundles in the callosum. However, no significant statistical difference in L-values was noted (P=0.44). CONCLUSION DTI metrics p and q have the potential to quantify the diffusion and anisotropy in various tissues thereby gaining information about their internal architecture. The results also suggest that significant differences of DTI metrics p and q between epidermoid and the splenium of the corpus callosum are due to the difference in structural organization within them.
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Affiliation(s)
- K Srinivasan
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology Trivandrum, India
| | - B Thomas
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology Trivandrum, India.
| | - D Shah
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology Trivandrum, India
| | - S K Kannath
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology Trivandrum, India
| | - G Menon
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - S Sandhyamani
- Department of Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - C Kesavadas
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology Trivandrum, India
| | - T R Kapilamoorthy
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology Trivandrum, India
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Medhi G, Saini J, Pandey P, Mahadevan A, Prasad C. T1 Hyperintense Prepontine Mass with Restricted Diffusion--A White Epidermoid or a Neuroenteric Cyst? J Neuroimaging 2015; 25:841-3. [PMID: 25682999 DOI: 10.1111/jon.12226] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 08/23/2014] [Accepted: 09/13/2014] [Indexed: 11/27/2022] Open
Abstract
Neuroenteric cysts (NC) are benign, congenital malformation which are of endodermal origin commonly located in the central nervous system. We report a case of intracranial NC with squamous metaplasia and xanthogranulomatous response masquerading as a white epidermoid on conventional MRI sequences. Lesion showed two components on T2W-images. We observed differential diffusion characteristics including fractional anisotropy, radial diffusivity and axial diffusivity within the two components of the lesion.
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Affiliation(s)
- Gorky Medhi
- Neuroimaging and Interventional Radiology Department, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Jitender Saini
- Neuroimaging and Interventional Radiology Department, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Paritosh Pandey
- Neurosurgery Department, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Anita Mahadevan
- Neuropathology Department, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India
| | - Chandrajit Prasad
- Neuroimaging and Interventional Radiology Department, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, Karnataka, India
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Ma L, Song ZJ. Differentiation between low-grade and high-grade glioma using combined diffusion tensor imaging metrics. Clin Neurol Neurosurg 2013; 115:2489-95. [DOI: 10.1016/j.clineuro.2013.10.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 09/27/2013] [Accepted: 10/02/2013] [Indexed: 10/26/2022]
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Histogram analysis of apparent diffusion coefficient map of standard and high B-value diffusion MR imaging in head and neck squamous cell carcinoma: a correlation study with histological grade. Acad Radiol 2012; 19:1233-40. [PMID: 22818788 DOI: 10.1016/j.acra.2012.04.019] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Revised: 04/20/2012] [Accepted: 04/23/2012] [Indexed: 01/18/2023]
Abstract
RATIONALE AND OBJECTIVES A histologic grade in head and neck squamous cell carcinoma (HNSCC) is clinically important because of its association with prognosis. The purpose of this study was to investigate the efficacy of histographic analysis of apparent diffusion coefficient (ADC) maps on the basis of the entire tumor volume in differentiating histologic grades in HNSCC at standard (b = 1000 s/mm(2)) and high (b = 2000 s/mm(2)) b values. MATERIALS AND METHODS Fifty-four patients with HNSCC, including well-differentiated (WD; n = 35), moderately differentiated (MD; n = 13) and poorly differentiated (PD; n = 6) carcinomas, were retrospectively evaluated. ADC maps were obtained at two different b values (1000 and 2000 s/mm(2)) in each patient. Tumors were delineated on each slice of ADC maps, and data were collected to obtain a histogram for the entire tumor volume. Histographic parameters were calculated, including mean, standard deviation, kurtosis, skewness, and the ratio of the kurtosis measured at b values of 1000 and 2000 s/mm(2). These parameters were correlated with histologic grades. RESULTS There was no significant correlation between tumor grades and histographic parameters obtained from ADC maps at b = 1000 s/mm(2). However, mean ADC at b = 2000 s/mm(2) was significantly higher in WD HNSCC (881 ± 131 × 10(-6) mm(2)/s) than in MD and PD HNSCC (770 ± 163 and 780 ± 158 × 10(-6) mm(2)/s, respectively) (P < .05). Kurtosis ratio was significantly higher in PD HNSCC (115 ± 10%) compared to WD and MD HNSCC (91 ± 21% and 86 ± 26%, respectively) (P < .05). Diagnostic accuracy was 100%, 76.9%, and 65.8% for PD, MD, and WD HNSCC, respectively. CONCLUSIONS Histographic analysis of ADC maps on the basis of the entire tumor volume can be useful in differentiating histologic grades of HNSCC using mean ADC at b = 2000 s/mm(2) and kurtosis ratio.
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Wang S, Kim S, Chawla S, Wolf RL, Knipp DE, Vossough A, O'Rourke DM, Judy KD, Poptani H, Melhem ER. Differentiation between glioblastomas, solitary brain metastases, and primary cerebral lymphomas using diffusion tensor and dynamic susceptibility contrast-enhanced MR imaging. AJNR Am J Neuroradiol 2011; 32:507-14. [PMID: 21330399 DOI: 10.3174/ajnr.a2333] [Citation(s) in RCA: 132] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Glioblastomas, brain metastases, and PCLs may have similar enhancement patterns on MR imaging, making the differential diagnosis difficult or even impossible. The purpose of this study was to determine whether a combination of DTI and DSC can assist in the differentiation of glioblastomas, solitary brain metastases, and PCLs. MATERIALS AND METHODS Twenty-six glioblastomas, 25 brain metastases, and 16 PCLs were retrospectively identified. DTI metrics, including FA, ADC, CL, CP, CS, and rCBV were measured from the enhancing, immediate peritumoral and distant peritumoral regions. A 2-level decision tree was designed, and a multivariate logistic regression analysis was used at each level to determine the best model for classification. RESULTS From the enhancing region, significantly elevated FA, CL, and CP and decreased CS values were observed in glioblastomas compared with brain metastases and PCLs (P < .001), whereas ADC, rCBV, and rCBV(max) values of glioblastomas were significantly higher than those of PCLs (P < .01). The best model to distinguish glioblastomas from nonglioblastomas consisted of ADC, CS (or FA) from the enhancing region, and rCBV from the immediate peritumoral region, resulting in AUC = 0.938. The best predictor to differentiate PCLs from brain metastases comprised ADC from the enhancing region and CP from the immediate peritumoral region with AUC = 0.909. CONCLUSIONS The combination of DTI metrics and rCBV measurement can help in the differentiation of glioblastomas from brain metastases and PCLs.
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Affiliation(s)
- S Wang
- Department of Radiology, Division of Neuroradiology, Hospital of the University of Pennsylvania, Philadelphia, 19104, USA.
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Saksena S, Jain R, Narang J, Scarpace L, Schultz LR, Lehman NL, Hearshen D, Patel SC, Mikkelsen T. Predicting survival in glioblastomas using diffusion tensor imaging metrics. J Magn Reson Imaging 2011; 32:788-95. [PMID: 20882608 DOI: 10.1002/jmri.22304] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To retrospectively correlate various diffusion tensor imaging (DTI) metrics in patients with glioblastoma multiforme (GBM) with patient survival analysis and also degree of tumor proliferation index determined histologically. MATERIALS AND METHODS Thirty-four patients with histologically confirmed treatment naive GBMs underwent DTI on a 3.0 Tesla (T) scanner. Region-of-interest was placed on the whole lesion including the enhancing as well as nonenhancing component of the lesion to determine the various DTI metrics. Kaplan-Meier estimates and Cox proportional hazards regression methods were used to assess the relationship of DTI metrics (minimum and mean values) and Ki-67 with progression free survival (PFS). To study the relationship between DTI metrics and Ki-67, Pearson's correlation coefficient was computed. RESULTS Univariate analysis showed that patients with fractional anisotropy (FA)(mean) ≤ 0.2, apparent diffusion coefficient (ADC)(min) ≤ 0.6, planar anisotropy (CP)(min) ≤ 0.002, spherical anisotropy (CS)(mean) > 0.68 and Ki-67 > 0.3 had lower PFS rate. The multivariate analysis demonstrated that only CP(min) was the best predictor of survival in these patients, after adjusting for age, Karnofsky performance scale and extent of resection. No significant correlation between DTI metrics and Ki-67 were observed. CONCLUSION DTI metrics can be used as a sensitive and early indicator for PFS in patients with glioblastomas. This could be useful for treatment planning as high-grade gliomas with lower ADC(min), FA(mean), CP(min), and higher CS(mean) values may be treated more aggressively.
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Affiliation(s)
- Sona Saksena
- Department of Radiology, Henry Ford Health System, Detroit, Michigan 48202, USA
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Spalice A, Nicita F, Papetti L, Ursitti F, Di Biasi C, Parisi P, Ruggieri M, Iannetti P. Usefulness of diffusion tensor imaging and fiber tractography in neurological and neurosurgical pediatric diseases. Childs Nerv Syst 2010; 26:995-1002. [PMID: 20552206 DOI: 10.1007/s00381-010-1192-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Accepted: 05/23/2010] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Diffusion tensor imaging (DTI) with fiber tractography (FT) is a recently introduced imaging technique that is unique in providing detailed imaging of white matter (WM) tracts and connectivity between different regions of the brain not easily appreciated with other imaging methods. DISCUSSION DTI has been used in recent years to investigate several disease conditions involving WM, including brain malformations, cerebral ischemia, multiple sclerosis, neurocutaneous syndromes, and brain tumors. CONCLUSION In this paper, we focus our attention on the main applications of DTI-FT in the field of pediatric neurology, adding our personal experience.
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Affiliation(s)
- Alberto Spalice
- Department of Pediatrics, Child Neurology Division, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
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Pérez-Iglesias R, Tordesillas-Gutiérrez D, Barker GJ, McGuire PK, Roiz-Santiañez R, Mata I, de Lucas EM, Quintana F, Vazquez-Barquero JL, Crespo-Facorro B. White matter defects in first episode psychosis patients: A voxelwise analysis of diffusion tensor imaging. Neuroimage 2010; 49:199-204. [DOI: 10.1016/j.neuroimage.2009.07.016] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2009] [Revised: 07/10/2009] [Accepted: 07/13/2009] [Indexed: 11/30/2022] Open
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