Role of diffusion tensor imaging in characterization and preoperative planning of brain neoplasms

Background and purpose

DTI is an MR imaging measure of brain tissue integrity. It gives precise information about the involvement and integrity of the white matter tracts in the immediate region surrounding tumors. The purpose of our study is to evaluate the role of DTI in characterization and preoperative assessment of brain neoplasm.

Materials and methods

32 patients with intracranial neoplasm were included in this study which was conducted during a 2 year period. Conventional MRI before and after IV Gadolinium administration was done followed by DTI and diffusion tensor tractography, with FA and ADC value measurements of different white matter tracts in direct relation to the tumor. The values obtained were compared to the normal unaffected tract in the contralateral side.

Results

White matter involvement by a tumor was classified according to the criteria of displacement, infiltration, disruption or edema. Patients were classified into two main groups according to the tumor type: benign and malignant groups. Prevalence of tract displacement was higher among benign group in comparison to the malignant group with significant difference in between by using chi-square test (P value <0.05). While prevalence of disruption was higher among the malignant group, in comparison to the benign group significant difference was noted in between by using chi-square test. (P value <0.05).

Conclusion

The information provided by DT imaging further defined precise relationships between the sub cortical white matter structures and the cerebral neoplasm. This potentially has a role in tumor characterization, and more importantly in surgical planning.