Glioma infiltration of the corpus callosum: early signs detected by DTI

J Neurooncol. 2013 Apr;112(2):217-22. doi: 10.1007/s11060-013-1049-y. Epub 2013 Jan 24.

Abstract

The most frequent primary brain tumors, anaplastic astrocytomas (AA) and glioblastomas (GBM): tend to invasion of the surrounding brain. Histopathological studies found malignant cells in macroscopically unsuspicious brain parenchyma remote from the primary tumor, even affecting the contralateral hemisphere. In early stages, diffuse interneural infiltration with changes of the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) is suspected. The purpose of this study was to investigate the value of DTI as a possible instrument of depicting evidence of tumor invasion into the corpus callosum (CC). Preoperatively, 31 patients with high-grade brain tumors (8 AA and 23 GBM) were examined by MRI at 3 T, applying a high-resolution diffusion tensor imaging (DTI) sequence. ADC- and FA-values were analyzed in the tumor-associated area of the CC as identified by fiber tracking, and were compared to matched healthy controls. In (MR-)morphologically normal appearing CC the ADC values were elevated in the tumor patients (n = 22; 0.978 × 10(-3) mm²/s) compared to matched controls (0.917 × 10(-3) mm²/s, p < 0.05), and the corresponding relative FA was reduced (rFA: 88 %, p < 0.01). The effect was pronounced in case of affection of the CC visible on MRI (n = 9; 0.978 × 10(-3) mm²/s, p < 0.05; rFA: 72 %, p < 0.01). Changes in diffusivity and anisotropy in the CC can be interpreted as an indicator of tumor spread into the contralateral hemisphere not visible on conventional MRI.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anisotropy
  • Brain Neoplasms / mortality
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / surgery
  • Case-Control Studies
  • Corpus Callosum / pathology*
  • Corpus Callosum / surgery
  • Diffusion Magnetic Resonance Imaging*
  • Diffusion Tensor Imaging*
  • Early Detection of Cancer
  • Female
  • Follow-Up Studies
  • Glioma / mortality
  • Glioma / pathology*
  • Glioma / surgery
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Prognosis
  • Survival Rate
  • Young Adult