Comparative evaluation of dynamic contrast-enhanced perfusion with diffusion tensor imaging metrics in assessment of corticospinal tract infiltration in malignant glioma.
OBJECTIVE
To compare dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) with diffusion tensor imaging (DTI) for predicting tumor infiltration in a conventional MRI normal-appearing internal capsule adjacent to the tumor in patients with glioblastoma multiforme.


METHODS
Thirty patients with glioblastoma multiforme underwent a neurological examination for motor assessment, DCE MRI, and DTI. On fused DCE and DTI images, regions of interest were placed on the normal-appearing internal capsule and the corresponding region of the contralateral internal capsule. These patients were pooled into group 1 (improved after surgery, n = 9) and group 2 (did not improve after surgery, n = 21) on the basis of motor strength. The DTI and perfusion metrics were statistically analyzed to look for a predictor of motor functionality.


RESULTS
Multivariate logistic regression analysis showed only cerebral blood volume to be the predictor of improvement in motor functionality after surgery (P = 0.043).


CONCLUSIONS
We conclude that cerebral blood volume appears to be the predictor of motor functionality after surgery and may indirectly suggest tumor infiltration, whereas DTI helps to precisely localize the fiber tracts.
Awasthi
Rishi
R
Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Verma
Sanjay Kumar
SK
Haris
Mohammad
M
Singh
Anup
A
Behari
Sanjay
S
Jaiswal
Awadhesh Kumar
AK
Rajput
Dinesh
D
Pandey
Rakesh
R
Rathore
Ram K S
RK
Pandey
Chandra M
CM
Gupta
Rakesh K
RK
D000328:Adult; D001810:Blood Volume; D001921:Brain / Q000098:blood supply / Q000473:pathology; D001931:Brain Mapping / Q000379:methods; D001932:Brain Neoplasms / Q000473:pathology*; D002560:Cerebrovascular Circulation; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D005909:Glioblastoma / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011237:Predictive Value of Tests; D011712:Pyramidal Tracts / Q000473:pathology*; D012189:Retrospective Studies
D003287:Contrast Media