Patterning of corpus callosum integrity in glioma observed by MRI: Effect of 2D bi-axial lamellar brain architecture

J Neurooncol. 2019 Aug;144(1):165-177. doi: 10.1007/s11060-019-03217-9. Epub 2019 Jul 1.

Abstract

Purpose: Corpus callosum (CC) is a main channel histologically for glioma spreading, downgrading the prognosis, the infiltration occurring through cellular reaction-diffusion process. Preliminary clinical trial indicates that CC's surgical interruption appreciably enhances clinical outcome. We aim to find how high-grade glioma phenomenology is reflected in CC parameters, including various 3D diffusion eigenvalues differentially, whereby this information may be utilized for planning radiotherapy and surgical intervention.

Methods: Using 3 Tesla MRI diffusion-tensor imaging of glioma patients and matched controls, we formulated the callosal volume, fibre count, and 3D directional diffusivity eigenvalues (λ123), utilizing FDT/FMRIB-based analysis.

Results: In glioma, the callosal volume, fibre count and normalized volume decreases (p < 0.001), while axial diffusivity λ1 and radial diffusivity component λ2 significantly increase (p = 0.03, p = 0.04). Though not expected, the other radial diffusivity component λ3 remains unchanged (p = 0.11). Increase of λ1 and λ2 is due to gliomatous migration across the two directions (eigenvectors of λ1, λ2), which correlate respectively with medio-lateral commissural fibres and dorso-ventral perforating fibres in CC. These are corroborated by collateral radiological findings and immunohistological staining of those two fibre-systems in cat and human.

Conclusion: In glioma, the two diffusivities (λ1, λ2), enhance due to fluidic edema permeation through CC's bi-axial lamina-type structural scaffold, formed by mediolateral commissural fibres and dorsoventral perforating cingulo-septal fibres. On other hand, the two radial diffusivities (λ2, λ3) are physiologically different and can be distinguished as lamellar diffusivity and focal diffusivity respectively. Lamellar diffusivity λ2 needs to be considered for MRI-assisted surgical intervention and radiotherapy planning in glioma.

Keywords: Corpus callosum; Diffusion tensor imaging; Glioma; Infiltration of tumor; Radial diffusivity; Radiotherapy planning.

MeSH terms

  • Adult
  • Brain / diagnostic imaging
  • Brain / pathology*
  • Case-Control Studies
  • Corpus Callosum / diagnostic imaging
  • Corpus Callosum / pathology*
  • Diffusion Tensor Imaging / methods*
  • Female
  • Follow-Up Studies
  • Glioma / diagnostic imaging
  • Glioma / pathology*
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Male
  • Prognosis