Diffusion Tensor Imaging of Tract Involvement in Children with Pontine Tumors

Overview

Journal AJNR Am J Neuroradiol

Specialty Neurology

Date 2006 Apr 14

PMID 16611765

Citations 32

Authors

K J Helton

N S Phillips

R B Khan

F A Boop

R A Sanford

P Zou

C S Li

J W Langston

R J Ogg

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: Conventional MR imaging permits subcategorization of brain stem tumors by location and focality; however, assessment of white matter tract involvement by tumor is limited. Diffusion tensor imaging (DTI) is a promising method for visualizing white matter tract tumor involvement supratentorially. We investigated the ability of DTI to visualize and quantify white matter tract involvement in pontine tumors.

Methods And Materials: DTI data (echo-planar, 1.5T) were retrospectively analyzed in 7 patients with pontine tumors (6 diffuse, 1 focal), 4 patient controls, and 5 normal volunteers. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were calculated from the diffusion tensor in 6 regions of interest: bilateral corticospinal tracts, transverse pontine fibers, and medial lemnisci. Relationships between FA and ADC values and results of the neurologic examinations were evaluated.

Results: The corticospinal tracts and transverse pontine fibers were affected more often than the medial lemnisci. The DTI parameters (FA and ADC) were significantly altered in all tracts of patients with pontine tumors (P < .05), compared with those values in the control groups. A marginally significant (P = .057) association was seen between the severity of cranial nerve deficit and decreased FA.

Conclusion: DTI provided superior visualization and quantification of tumor involvement in motor, sensory, and transverse pontine tracts, compared with information provided by conventional MR imaging. Thus, DTI may be a sensitive measure of tract invasion. Further prospective studies are warranted to assess the ability of DTI to delineate tumor focality and improve risk stratification in children with pontine tumors.

Citing Articles

NTMS based tractography and segmental diffusion analysis in patients with brainstem gliomas: Risk stratification and clinical potential.

Weiss L, Roth F, Rea-Ludmann P, Rosenstock T, Picht T, Vajkoczy P Brain Spine. 2024; 4:102753.

PMID: 38510608 PMC: 10951762. DOI: 10.1016/j.bas.2024.102753.

The Role of Advanced MRI Sequences in the Diagnosis and Follow-Up of Adult Brainstem Gliomas: A Neuroradiological Review.

Guarnera A, Romano A, Moltoni G, Ius T, Palizzi S, Romano A Tomography. 2023; 9(4):1526-1537.

PMID: 37624115 PMC: 10457939. DOI: 10.3390/tomography9040122.

Current state of pediatric neuro-oncology imaging, challenges and future directions.

Nabavizadeh A, Barkovich M, Mian A, NGo V, Kazerooni A, Villanueva-Meyer J Neoplasia. 2023; 37:100886.

PMID: 36774835 PMC: 9945752. DOI: 10.1016/j.neo.2023.100886.

White matter alterations in pediatric brainstem glioma: An national brain tumor registry of China study.

Zhang P, Gu G, Duan Y, Zhuo Z, Pan C, Zuo P Front Neurosci. 2022; 16:986873.

PMID: 36161172 PMC: 9500240. DOI: 10.3389/fnins.2022.986873.

Optimized Tractography Mapping and Quantitative Evaluation of Pyramidal Tracts for Surgical Resection of Insular Gliomas: a Correlative Study with Diffusion Tensor Imaging-Derived Metrics and Patient Motor Strength.

Li Y, Hou Y, Li Q, Tang J, Lu J J Digit Imaging. 2022; 35(2):356-364.

PMID: 35064370 PMC: 8921407. DOI: 10.1007/s10278-021-00578-4.

References

Stieltjes B, Kaufmann W, van Zijl P, Fredericksen K, Pearlson G, Solaiyappan M . Diffusion tensor imaging and axonal tracking in the human brainstem. Neuroimage. 2001; 14(3):723-35. DOI: 10.1006/nimg.2001.0861. View

Albright A, Packer R, Zimmerman R, RORKE L, Boyett J, Hammond G . Magnetic resonance scans should replace biopsies for the diagnosis of diffuse brain stem gliomas: a report from the Children's Cancer Group. Neurosurgery. 1993; 33(6):1026-9; discussion 1029-30. DOI: 10.1227/00006123-199312000-00010. View

Mukherjee P, Miller J, Shimony J, Philip J, Nehra D, Snyder A . Diffusion-tensor MR imaging of gray and white matter development during normal human brain maturation. AJNR Am J Neuroradiol. 2002; 23(9):1445-56. PMC: 7976805. View

Gauvain K, McKinstry R, Mukherjee P, Perry A, Neil J, Kaufman B . Evaluating pediatric brain tumor cellularity with diffusion-tensor imaging. AJR Am J Roentgenol. 2001; 177(2):449-54. DOI: 10.2214/ajr.177.2.1770449. View

Field A, Alexander A, Wu Y, Hasan K, Witwer B, Badie B . Diffusion tensor eigenvector directional color imaging patterns in the evaluation of cerebral white matter tracts altered by tumor. J Magn Reson Imaging. 2004; 20(4):555-62. DOI: 10.1002/jmri.20169. View

Tien R, Felsberg G, Friedman H, Brown M, MacFall J . MR imaging of high-grade cerebral gliomas: value of diffusion-weighted echoplanar pulse sequences. AJR Am J Roentgenol. 1994; 162(3):671-7. DOI: 10.2214/ajr.162.3.8109520. View

Lesniak M, Klem J, Weingart J, Carson Sr B . Surgical outcome following resection of contrast-enhanced pediatric brainstem gliomas. Pediatr Neurosurg. 2004; 39(6):314-22. DOI: 10.1159/000075260. View

Basser P, Pajevic S, Pierpaoli C, Duda J, Aldroubi A . In vivo fiber tractography using DT-MRI data. Magn Reson Med. 2000; 44(4):625-32. DOI: 10.1002/1522-2594(200010)44:4<625::aid-mrm17>3.0.co;2-o. View

Tropine A, Vucurevic G, Delani P, Boor S, Hopf N, Bohl J . Contribution of diffusion tensor imaging to delineation of gliomas and glioblastomas. J Magn Reson Imaging. 2004; 20(6):905-12. DOI: 10.1002/jmri.20217. View

10.

Barkovich A, Krischer J, Kun L, Packer R, Zimmerman R, Freeman C . Brain stem gliomas: a classification system based on magnetic resonance imaging. Pediatr Neurosurg. 1990; 16(2):73-83. DOI: 10.1159/000120511. View

11.

Nimsky C, Ganslandt O, Hastreiter P, Wang R, Benner T, Sorensen A . Preoperative and intraoperative diffusion tensor imaging-based fiber tracking in glioma surgery. Neurosurgery. 2004; 56(1):130-7. DOI: 10.1227/01.neu.0000144842.18771.30. View

12.

Reese T, Heid O, Weisskoff R, Wedeen V . Reduction of eddy-current-induced distortion in diffusion MRI using a twice-refocused spin echo. Magn Reson Med. 2003; 49(1):177-82. DOI: 10.1002/mrm.10308. View

13.

Price S, Pena A, Burnet N, Jena R, Green H, Carpenter T . Tissue signature characterisation of diffusion tensor abnormalities in cerebral gliomas. Eur Radiol. 2004; 14(10):1909-17. DOI: 10.1007/s00330-004-2381-6. View

14.

Conturo T, Lori N, Cull T, Akbudak E, Snyder A, Shimony J . Tracking neuronal fiber pathways in the living human brain. Proc Natl Acad Sci U S A. 1999; 96(18):10422-7. PMC: 17904. DOI: 10.1073/pnas.96.18.10422. View

15.

Clark C, Barrick T, Murphy M, Bell B . White matter fiber tracking in patients with space-occupying lesions of the brain: a new technique for neurosurgical planning?. Neuroimage. 2003; 20(3):1601-8. DOI: 10.1016/j.neuroimage.2003.07.022. View

16.

Phillips N, Sanford R, Helton K, Boop F, Zou P, Tekautz T . Diffusion tensor imaging of intraaxial tumors at the cervicomedullary and pontomedullary junctions. Report of two cases. J Neurosurg. 2005; 103(6 Suppl):557-62. DOI: 10.3171/ped.2005.103.6.0557. View

17.

Cartmill M, Punt J . Diffuse brain stem glioma. A review of stereotactic biopsies. Childs Nerv Syst. 1999; 15(5):235-7; discussion 238. DOI: 10.1007/s003810050379. View

18.

Boviatsis E, Voumvourakis K, Goutas N, Kazdaglis K, Kittas C, Kelekis D . Stereotactic biopsy of brain stem lesions. Minim Invasive Neurosurg. 2002; 44(4):226-9. DOI: 10.1055/s-2001-19930. View

19.

Allen J, Siffert J . Contemporary chemotherapy issues for children with brainstem gliomas. Pediatr Neurosurg. 1996; 24(2):98-102. DOI: 10.1159/000121024. View

20.

Fischbein N, PRADOS M, Wara W, Russo C, Edwards M, Barkovich A . Radiologic classification of brain stem tumors: correlation of magnetic resonance imaging appearance with clinical outcome. Pediatr Neurosurg. 1996; 24(1):9-23. DOI: 10.1159/000121010. View