title: Diffusion tensor-based tumor infiltration index cannot discriminate vasogenic edema from tumor-infiltrated edema.
abstract: Diffusion tensor imaging (DTI) by magnetic resonance imaging (MRI) is now used not only for delineating white matter fiber tracts, but also for assessing the histological characteristics of pathological tissues. Among these uses, predicting the extent or existence of tumor cell invasion into white matter by DTI is under extensive investigation. The previously reported tumor infiltration index (TII) holds great potential for the discrimination of pure vasogenic edema from tumor-infiltrated edema. However, conflicting data are being reported questioning the clinical value of TII. The present investigation reevaluated the utility of TII in patients with meningioma or glioma. We found that TII was unable to discriminate vasogenic from tumor-infiltrated edema. Conversely, detailed voxel-by-voxel comparison of TII and (11)C-methionie PET in the T2-hyperintense area of gliomas showed that TII and (11)C-methionie PET has a positive correlation, suggesting that, although TII is unable to discriminate the cause of edema, the extent of tumor cell invasion into white matter is depicted in gliomas by TII. These data suggest that TII involves both vasogenic and tumor-infiltrated factors, rather than only a single factor. A more intensive investigation is required to reach a complete understanding of TII.
authors.affiliation: Department of Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadoka, Suita, Osaka, 565-0871, Japan. m-kinoshita@nsurg.med.osaka-u.ac.jp
authors.forename: Manabu
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Tetsu
authors.initials: T
authors.lastname: Goto
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Okita
authors.forename: Naoki
authors.initials: N
authors.lastname: Kagawa
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Kishima
authors.forename: Naoya
authors.initials: N
authors.lastname: Hashimoto
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yoshimine
mesh_terms: D000328:Adult; D000368:Aged; D001929:Brain Edema / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002247:Carbon Isotopes; D056324:Diffusion Tensor Imaging; D005260:Female; D005910:Glioma / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008579:Meningioma / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008715:Methionine; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods; D013223:Statistics as Topic; D055815:Young Adult
chemical_list: D002247:Carbon Isotopes; D008715:Methionine
references.citation: AJNR Am J Neuroradiol. 2003 May;24(5):937-41
references.pmid: 12748097
references.citation: Radiology. 2004 Jul;232(1):221-8
references.pmid: 15220505
references.citation: J Neurosurg. 1995 Oct;83(4):682-9
references.pmid: 7674019
references.citation: Magn Reson Med. 2005 Nov;54(5):1216-25
references.pmid: 16200554
references.citation: Biophys J. 1994 Jan;66(1):259-67
references.pmid: 8130344
references.citation: Neuroimage. 2008 Jan 1;39(1):369-82
references.pmid: 17911032
references.citation: Neurology. 1998 May;50(5):1316-22
references.pmid: 9595980
references.citation: J Magn Reson B. 1994 Mar;103(3):247-54
references.pmid: 8019776
references.citation: J Neurooncol. 2000 Dec;50(3):215-26
references.pmid: 11263501
references.citation: Neuroimage. 2009 Feb 1;44(3):653-60
references.pmid: 18951985
references.citation: Ann Neurol. 2002 Mar;51(3):377-80
references.pmid: 11891834
references.citation: Neuroimage. 2007 Feb 1;34(3):949-56
references.pmid: 17166744
references.citation: AJNR Am J Neuroradiol. 2008 Jun;29(6):1176-82
references.pmid: 18388218
references.citation: J Neurosurg. 2007 Jan;106(1):128-33
references.pmid: 17236498
references.citation: J Neurooncol. 2003 Jun;63(2):109-16
references.pmid: 12825815
references.citation: Neuroimage. 2004 Sep;23(1):46-53
references.pmid: 15325351
references.citation: Radiology. 2006 Apr;239(1):217-22
references.pmid: 16484348
references.citation: J Neurosurg. 2005 Apr;102(4):664-72
references.pmid: 15871509
references.citation: Neuroimage. 2006 May 1;30(4):1219-29
references.pmid: 16364659
references.citation: Neuroimage. 2009 Apr 1;45(2):312-8
references.pmid: 19111621
references.citation: Neurosurgery. 2006 Apr;58(4 Suppl 2):ONS-292-303; discussion ONS-303-4
references.pmid: 16582653
references.citation: J Nucl Med. 2007 Sep;48(9):1468-81
references.pmid: 17704239
references.citation: Neurosurgery. 2005;56(1):130-7; discussion 138
references.pmid: 15617595
references.citation: J Nucl Med. 2004 Aug;45(8):1293-8
references.pmid: 15299051
references.citation: Radiology. 2004 Aug;232(2):451-60
references.pmid: 15215555
references.citation: Neuroimage. 2005 Apr 1;25(2):424-9
references.pmid: 15784421
references.citation: Neurosurgery. 2005 Jan;56(1 Suppl):98-109; discussion 98-109
references.pmid: 15799797
references.citation: J Appl Clin Med Phys. 2004 Summer;5(3):66-79
references.pmid: 15753941
references.citation: Clin Cancer Res. 2004 Nov 1;10(21):7163-70
references.pmid: 15534088
references.citation: Neuroimage. 2008 Oct 15;43(1):29-35
references.pmid: 18672074
references.citation: Int J Appl Radiat Isot. 1979 Jul;30(7):393-9
references.pmid: 478664