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Biexponential diffusion alterations in the normal‐appearing white matter of glioma patients might indicate the presence of global vasogenic edema
Author(s) -
Horváth Andrea,
Perlaki Gábor,
Tóth Arnold,
Orsi Gergely,
Nagy Szilvia,
Dóczi Tamás,
Horváth Zsolt,
Bogner Péter
Publication year - 2016
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25202
Subject(s) - white matter , glioma , effective diffusion coefficient , diffusion mri , medicine , pathology , nuclear medicine , magnetic resonance imaging , radiology , cancer research
Purpose To investigate normal‐appearing white matter (NAWM) microstructure of glioma patients with biexponential diffusion analysis in order to reveal the nature of diffusion abnormalities and to assess whether they are region‐specific or global. Materials and Methods Twenty‐four newly diagnosed glioma patients (grade II–IV) and 24 matched control subjects underwent diffusion‐weighted imaging at 3T. Diffusion parameters were calculated using monoexponential and biexponential models. Apparent diffusion coefficient (ADC) values were measured in the entire NAWM of the hemisphere contralateral and ipsilateral to the tumor. In the contralateral NAWM, regional ADC values were assessed in the frontal, parietal, occipital, and temporal NAWM. Results ADC mono and ADC fast were significantly higher than control values in all investigated regions except the temporal NAWM ( P < 0.04). ADC slow was significantly increased in the total contralateral, frontal, and parietal NAWM ( P < 0.03), while p slow was decreased in both total hemispheric NAWM and the parietal NAWM of glioma patients compared to controls ( P < 0.04). ADC mono , ADC fast , ADC slow , and p slow were significantly different among the NAWM of the four lobes of the contralateral hemisphere in both groups ( P < 0.0001), and these regional differences were similar in patients and controls ( P > 0.05). Hemispheric ADC mono and p slow differences were different between groups ( P < 0.05). Conclusion Globally altered diffusion parameters suggest the presence of global vasogenic edema in the NAWM of glioma patients, which is further supported by the finding that regional differences in patients follow those found in controls. Alternatively, some tumor infiltration might contribute to diffusion abnormalities in the NAWM, especially in the tumor‐affected hemisphere. J. Magn. Reson. Imaging 2016;44:633–641.