Perifocal Zone of Brain Gliomas: Application of Diffusion Kurtosis and Perfusion MRI Values for Tumor Invasion Border Determination.
Natalia E ZakharovaArtem I BatalovEduard L PogosbekianIvan V ChekhoninSergey A GoryaynovAndrey E BykanovAnastasia N TyurinaSuzanna A GalstyanPavel V NikitinLyudmila M FadeevaDmitry Yu UsachevIgor N ProninPublished in: Cancers (2023)
(1) Purpose: To determine the borders of malignant gliomas with diffusion kurtosis and perfusion MRI biomarkers. (2) Methods: In 50 high-grade glioma patients, diffusion kurtosis and pseudo-continuous arterial spin labeling (pCASL) cerebral blood flow (CBF) values were determined in contrast-enhancing area, in perifocal infiltrative edema zone, in the normal-appearing peritumoral white matter of the affected cerebral hemisphere, and in the unaffected contralateral hemisphere. Neuronavigation-guided biopsy was performed from all affected hemisphere regions. (3) Results: We showed significant differences between the DKI values in normal-appearing peritumoral white matter and unaffected contralateral hemisphere white matter. We also established significant ( p < 0.05) correlations of DKI with Ki-67 labeling index and Bcl-2 expression activity in highly perfused enhancing tumor core and in perifocal infiltrative edema zone. CBF correlated with Ki-67 LI in highly perfused enhancing tumor core. One hundred percent of perifocal infiltrative edema tissue samples contained tumor cells. All glioblastoma samples expressed CD133. In the glioblastoma group, several normal-appearing white matter specimens were infiltrated by tumor cells and expressed CD133. (4) Conclusions: DKI parameters reveal changes in brain microstructure invisible on conventional MRI, e.g., possible infiltration of normal-appearing peritumoral white matter by glioma cells. Our results may be useful for plotting individual tumor invasion maps for brain glioma surgery or radiotherapy planning.
Keyphrases
- white matter
- contrast enhanced
- high grade
- multiple sclerosis
- diffusion weighted imaging
- magnetic resonance imaging
- cerebral blood flow
- magnetic resonance
- end stage renal disease
- ejection fraction
- newly diagnosed
- low grade
- chronic kidney disease
- minimally invasive
- radiation therapy
- computed tomography
- poor prognosis
- neoadjuvant chemotherapy
- single molecule
- brain injury
- prognostic factors
- genome wide
- fine needle aspiration
- high resolution
- room temperature
- atrial fibrillation
- basal cell carcinoma
- functional connectivity
- binding protein
- long non coding rna