Diffusion kurtosis imaging of gliomas grades II and III - a study of perilesional tumor infiltration, tumor grades and subtypes at clinical presentation
Article Category: Research Articles
Published Online: Feb 15, 2017
Page range: 121 - 129
Received: Aug 15, 2016
Accepted: Jan 08, 2017
DOI: https://doi.org/10.1515/raon-2017-0010
Keywords
© 2017 Anna F. Delgado, Markus Fahlström, Markus Nilsson, Shala G. Berntsson, Maria Zetterling, Sylwia Libard, Irina Alafuzoff, Danielle van Westen, Jimmy Lätt, Anja Smits, Elna-Marie Larsson
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Background
Diffusion kurtosis imaging (DKI) allows for assessment of diffusion influenced by microcellular structures. We analyzed DKI in suspected low-grade gliomas prior to histopathological diagnosis. The aim was to investigate if diffusion parameters in the perilesional normal-appearing white matter (NAWM) differed from contralesional white matter, and to investigate differences between glioma malignancy grades II and III and glioma subtypes (astrocytomas and oligodendrogliomas).
Patients and methods
Forty-eight patients with suspected low-grade glioma were prospectively recruited to this institutional review board-approved study and investigated with preoperative DKI at 3T after written informed consent. Patients with histologically proven glioma grades II or III were further analyzed (n=35). Regions of interest (ROIs) were delineated on T2FLAIR images and co-registered to diffusion MRI parameter maps. Mean DKI data were compared between perilesional and contralesional NAWM (student’s
Results
There were significant differences in all mean DKI variables between perilesional and contralesional NAWM (
Conclusions
Mean DKI variables in perilesional NAWM differ significantly from contralesional NAWM, suggesting altered microstructure by tumor infiltration not depicted on morphological MRI. Histogram analysis of DKI data identifies differences between glioma grades and subtypes.