Usefulness of diffusion-weighted MRI with echo-planar technique in the evaluation of cellularity in gliomas
Corresponding Author
Takeshi Sugahara MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Department of Radiology, Kumamoto University School of Medicine, 1–1-1 Honjo, Kumamoto 860–8556, Japan.Search for more papers by this authorYukunori Korogi MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorMasato Kochi MD
Department of Neurosurgery, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorIchiro Ikushima MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorYoshinori Shigematu MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorToshinori Hirai MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorTomoko Okuda MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorLuxia Liang MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorYulin Ge MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorYasuyuki Komohara MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorYukitaka Ushio MD
Department of Neurosurgery, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorMutsumasa Takahashi MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorCorresponding Author
Takeshi Sugahara MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Department of Radiology, Kumamoto University School of Medicine, 1–1-1 Honjo, Kumamoto 860–8556, Japan.Search for more papers by this authorYukunori Korogi MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorMasato Kochi MD
Department of Neurosurgery, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorIchiro Ikushima MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorYoshinori Shigematu MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorToshinori Hirai MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorTomoko Okuda MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorLuxia Liang MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorYulin Ge MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorYasuyuki Komohara MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorYukitaka Ushio MD
Department of Neurosurgery, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorMutsumasa Takahashi MD
Department of Radiology, Kumamoto University School of Medicine, Kumamoto 860, Japan.
Search for more papers by this authorAbstract
The purpose of this study was to evaluate the utility of diffusion-weighted magnetic resonance imaging (MRI) with echo-planar imaging (EPI) technique in depicting the tumor cellularity and grading of gliomas. Twenty consecutive patients (13 men and 7 women, ranging in age from 13 to 69 years) with histologically proven gliomas were examined using a 1.5 T superconducting imager. Tumor cellularity, analyzed with National Institutes of Health Image 1.60 software on a Macintosh computer, was compared with the minimum apparent diffusion coefficient (ADC) and the signal intensity on the T2-weighted images. The relationship of the minimum ADC to the tumor grade was also evaluated. Tumor cellularity correlated well with the minimum ADC value of the gliomas (P = 0.007), but not with the signal intensity on the T2-weighted images. The minimum ADC of the high-grade gliomas was significantly higher than that of the low-grade gliomas. Diffusion-weighted MRI with EPI is a useful technique for assessing the tumor cellularity and grading of gliomas. This information is not obtained with conventional MRI and is useful for the diagnosis and characterization of gliomas. J. Magn. Reson. Imaging 1999;9:53–60 © 1999 Wiley-Liss, Inc.
REFERENCES
- 1 Russell D, Rubinstein L. Tumours of central neuroepithelial origin. In: LJ Rubenstein, editor. Pathology of tumours of the nervous system. Baltimore: Williams & Wilkins; 1989. p 83–350.
- 2 Black PM. Brain tumors. Part 1. N Engl J Med 1991; 324: 1471–1476, 1555–1564. Medline
- 3 Glantz MJ, Burger PC, Herndon JE II, et al. Influence of the type of surgery on the histologic diagnosis in patients with anaplastic gliomas. Neurology 1991; 41: 1741–1744. Medline
- 4 Aronen HJ, Gazit IE, Luis DN, et al. Cerebral blood volume maps of gliomas: comparison with tumor grade and histologic findings. Radiology 1994; 191: 41–51. Medline
- 5 Maeda M, Itoh S, Kimura H, et al. Tumor vascularity in the brain: evaluation with dynamic susceptibility-contrast MR imaging. Radiology 1993; 189: 233–238. Medline
- 6
Kleihues P,
Burger PC,
Schneithauer BW.
Histological typing of tumours of the central nervous system. 2nd ed.
Berlin: Springer-Verlag,
1993.
10.1007/978-3-642-84988-6 Google Scholar
- 7
Daumas-Duport C,
Schneithauer B,
O'Fallon J,
Kelly P.
Grading of astrocytomas: a simple and reproducible method.
Cancer
1988;
62: 2152–2165.
Medline
10.1002/1097-0142(19881115)62:10<2152::AID-CNCR2820621015>3.0.CO;2-T CAS PubMed Web of Science® Google Scholar
- 8 Hajnal JV, Doran M, Hall AS, et al. MR imaging of anisotropically restricted diffusion of water in the nervous system: technical, anatomic, and pathologic considerations. J Comput Assist Tomogr 1991; 15: 1–18. Medline
- 9 Le Bihan D, Breton E, Lallemand D, Grenier P, Cabanis E, Laval-Jeantet M. MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders. Radiology 1986; 161: 401–408. Medline
- 10 Tsuruda JS, Chew WM, Moseley ME, Norman D. Diffusion-weighted MR imaging of the brain: value of differentiating between extraaxial cysts and epidermoid tumors. AJNR Am J Neuroradiol 1990; 11: 925–931. Medline
- 11 Chien D, Buxton RB, Kwong KK, Brady TJ, Rosen BR. MR diffusion imaging of the human brain. J Comput Assist Tomogr 1990; 14: 514–520. Medline
- 12 Douek P, Turner R, Pekar J, Patronas N, Le Bihan D. MR color mapping of myelin fiber orientation. J Comput Assist Tomogr 1991: 15: 923–929. Medline
- 13 Henkelman RM. Diffusion-weighted MR imaging: a useful adjunct to clinical diagnosis or a scientific curiosity? AJNR Am J Neuroradiol 1990; 11: 932–934.
- 14 Le Bihan D, Douek P, Argyropoulou M, Turner R, Patronas N, Fulham M. Diffusion and perfusion magnetic resonance imaging in brain tumors. Top Magn Reson Imaging 1993; 5: 25–31. Medline
- 15 Sorensen AG, Buonanno FS, Gonzalez RG, et al. Hyperacute stroke: evaluation with combined multiplesection diffusion-weighted and hemodynamically weighted echo-planar MR imaging. Radiology 1996; 199: 391–401. Medline
- 16 Benveniste H, Hedlund LW, Johnson GA. Mechanism of detection of acute cerebral ischemia in rats by diffusion-weighted magnetic resonance microscopy. Stroke 1992; 23: 746–754. Medline
- 17 Mintrovitch J, Yang GY, Shimizu H, Kucharcxyk J, Chan PK, Weinstein PR. Diffusion-weighted magnetic resonance imaging of acute focal cerebral ischemia: comparison of signal intensity with changes in brain water and Na+, K+-ATPase activity. J Cereb Blood Flow Metab 1994; 14: 332–336. Medline
- 18 Tsuruda JS, Chew WM, Moseley ME, Norman D. Diffusion-weighted MR imaging of the brain: value of differentiating between extraaxial cysts and epidermoid tumors. AJNR Am J Neuroradiol 1990; 11: 925–931. Medline
- 19 Tien RD, Felsberg GJ, Friedman H, Brown M, MR imaging of high-grade cerebral gliomas: value of diffusion-weighted echoplanar pulse sequences. AJR Am J Roentgenol 1994; 162: 671–677. Medline
- 20 Le Bihan D, Breton E, Lallemand D, Grenier P, Cabanis E, Laval-Jeantet M. MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders. Radiology 1986; 161: 401–407. Medline
- 21 Hajnal JV, Doran M, Hall AS, et al. MR imaging of anisotropically restricted diffusion of water in the nervous system: technical, anatomic, and pathologic consideration. J Comput Assist Tomogr 1991; 15: 1–18. Medline
- 22 Tanner JE. Intracellular diffusion of water. Arch Biochem Biophys 1983; 224: 416–754. Medline
- 23 Brunberg JA, Chenevert TL, McKeever PE, et al. In vivo MR determination of water diffusion coefficients and diffusion anisotropy: correlation with structural alternation in gliomas of the cerebral hemispheres. AJNR Am J Neuroradiol 1995; 16: 361–371. Medline
- 24 Brunberg JA, Chenevert TL, Ross DA, et al. In vivo MR determination of water diffusion coefficients and diffusion anisotropy: correlation with structural alternation in astrocytomas of the cerebral hemispheres (abstr). In: Book of abstracts: American society of neuroradiology 1993. Chicago: American Society of Neuroradiology, 1993. p 71.
- 25 Atlas SW, Lavi E. Intra-axial brain tumors. SW Atlas. In: Magnetic resonance imaging of the brain and spine. 2nd ed. Philadelphia: Lippincott-Raven; 1992. p 88–108.
