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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 AJNR+Am+J+Neuroradiol
2013 ; 34
(6
): 1157-63
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gab.com Text
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Recovery of white matter tracts in regions of peritumoral FLAIR hyperintensity
with use of restriction spectrum imaging
#MMPMID23275591
McDonald CR
; White NS
; Farid N
; Lai G
; Kuperman JM
; Bartsch H
; Hagler DJ
; Kesari S
; Carter BS
; Chen CC
; Dale AM
AJNR Am J Neuroradiol
2013[Jun]; 34
(6
): 1157-63
PMID23275591
show ga
BACKGROUND AND PURPOSE: DTI is being increasingly used to visualize critical
white matter tracts adjacent to brain tumors before neurosurgical resection.
However, brain tumors, particularly high-grade gliomas, are typically surrounded
by regions of FLAIR hyperintensity that include edema, which increase isotropic
diffusion, degrading the ability of standard DTI to uncover orientation estimates
within these regions. We introduce a new technique, RSI, which overcomes this
limitation by removing the spherical, fast diffusion component introduced by
edema, providing better analysis of white matter architecture. MATERIALS AND
METHODS: A total of 10 patients with high-grade gliomas surrounded by FLAIR-HI
that at least partially resolved on follow-up imaging were included. All patients
underwent RSI and DTI at baseline (FLAIR-HI present) and at follow-up (FLAIR-HI
partially resolved). FA values obtained with RSI and DTI were compared within
regions of FLAIR-HI and NAWM at both time points. RESULTS: RSI showed higher FA
in regions of FLAIR-HI and NAWM relative to DTI, reflecting the ability of RSI to
specifically measure the slow, restricted volume fraction in regions of edema and
NAWM. Furthermore, a method by time interaction revealed that FA estimates
increased when the FLAIR-HI resolved by use of standard DTI but remained stable
with RSI. Tractography performed within the region of FLAIR-HI revealed the
superior ability of RSI to track fibers through severe edema relative to standard
DTI. CONCLUSIONS: RSI improves the quantification and visualization of white
matter tracts in regions of peritumoral FLAIR-HI associated with edema relative
to standard DTI and may provide a valuable tool for neurosurgical planning.