title: Assessment of therapeutic response in patients with brain abscess using diffusion tensor imaging.
abstract: BACKGROUND
  Accurate assessment of therapeutic response in patients with brain abscess (BA) is essential to direct appropriate therapy. This study was performed with an aim to see the treatment-induced changes in diffusion tensor imaging (DTI) indices (i.e., fractional anisotropy [FA] and mean diffusivity [MD]) in follow-up patients with BA after treatment.
  
  
  METHODS
  Twenty patients with BA were prospectively studied in this study. Diffusion tensor imaging in first follow-up was done in all after 1 week and in 6 at 4 weeks of the initial study.
  
  
  RESULTS
  The mean FA and MD values in first, second, and third studies were 0.28 +/- 0.03 and (0.81 +/- 0.07) x 10(-3) mm(2)/s, 0.18 +/- 0.09 and (1.08 +/- 0.09) x 10(-3) mm(2)/s, and 0.13 +/- 0.04 and (0.99 +/- 0.13) x 10(-3) mm(2)/s, respectively. The FA value was significantly (P < .01) decreased along with no significant change in MD value (P = .08) for 3 study periods. The mean volume (in milliliter) of the abscesses was 2.14 +/- 1.04, 1.34 +/- 0.45, and 0.77 +/- 0.14 in first, second, and third studies, respectively.
  
  
  CONCLUSIONS
  We conclude that the reduction in FA value reflects the down-regulation of the neuroinflammatory molecules in response to treatment in patient with BA and may be used to assess therapeutic response in these patients in future.
authors.affiliation: Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP 226014, India.
authors.forename: Kavindra
authors.initials: K
authors.lastname: Nath
authors.forename: Mahesh
authors.initials: M
authors.lastname: Ramola
authors.forename: Mazhar
authors.initials: M
authors.lastname: Husain
authors.forename: Manoj
authors.initials: M
authors.lastname: Kumar
authors.forename: Kashi
authors.initials: K
authors.lastname: Prasad
authors.forename: Rakesh
authors.initials: R
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D000328:Adult; D016880:Anisotropy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000378:metabolism / Q000473:pathology* / Q000628:therapy*; D002648:Child; D016207:Cytokines / Q000502:physiology; D056324:Diffusion Tensor Imaging; D004322:Drainage; D005500:Follow-Up Studies; D006801:Humans; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013238:Stereotaxic Techniques; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D016207:Cytokines