TY - JOUR
T1 - Diffusion tensor analysis of peritumoral edema using lambda chart analysis indicative of the heterogeneity of the microstructure within edema
AU - Morita, Ken Ichi
AU - Matsuzawa, Hitoshi
AU - Fujii, Yukihiko
AU - Tanaka, Ryuichi
AU - Kwee, Ingrid L.
AU - Nakada, Tsutomu
PY - 2005/2
Y1 - 2005/2
N2 - Object. Histopathological studies indicate that cerebral edema associated with tumors (peritumoral edema) does not represent a single pathophysiological or clinical entity. In this study the authors investigated peritumoral edema by performing lambda chart analysis (LCA), a noninvasive technique that can be used to make visible and analyze apparent water diffusivity in tissues in vivo, and assessed the utility of LCA in differentiating high-grade gliomas from nonglial tumors. Methods. The water diffusivity characteristics of peritumoral edema associated with four tumor groups - 12 high-grade gliomas, five low-grade gliomas, 11 metastatic tumors, and 15 meningiomas - were assessed in 43 patients by performing magnetic resonance imaging with the aid of a 3-tesla magnetic resonance imaging system. In all tumor groups, peritumoral edema exhibited greater trace values and reduced anisotropy compared with normal white matter. Edema associated with high-grade gliomas had significantly higher trace values than edema associated with the other three tumor groups, although the anisotropic angles of those groups were comparable. Conclusions. Lambda chart analysis identified two distinct types of peritumoral edema: edema associated with high-grade gliomas and edema associated with low-grade gliomas or nonglial tumors. The apparent water diffusivity was significantly greater in high-grade gliomas, whereas the anisotropy in these lesions was comparable to that of edema in other tumors. These findings indicated that water movement in areas of edema, predominantly in the extracellular spaces, was less restricted in high-grade gliomas, a phenomenon that likely reflected the destruction of the extracellular matrix ultrastructure by malignant cell infiltration and consequently greater water diffusion. Although preliminary, this study indicates that LCA could be used as a clinical tool for differentiating high-grade gliomas and for evaluating the extent of cellular infiltration.
AB - Object. Histopathological studies indicate that cerebral edema associated with tumors (peritumoral edema) does not represent a single pathophysiological or clinical entity. In this study the authors investigated peritumoral edema by performing lambda chart analysis (LCA), a noninvasive technique that can be used to make visible and analyze apparent water diffusivity in tissues in vivo, and assessed the utility of LCA in differentiating high-grade gliomas from nonglial tumors. Methods. The water diffusivity characteristics of peritumoral edema associated with four tumor groups - 12 high-grade gliomas, five low-grade gliomas, 11 metastatic tumors, and 15 meningiomas - were assessed in 43 patients by performing magnetic resonance imaging with the aid of a 3-tesla magnetic resonance imaging system. In all tumor groups, peritumoral edema exhibited greater trace values and reduced anisotropy compared with normal white matter. Edema associated with high-grade gliomas had significantly higher trace values than edema associated with the other three tumor groups, although the anisotropic angles of those groups were comparable. Conclusions. Lambda chart analysis identified two distinct types of peritumoral edema: edema associated with high-grade gliomas and edema associated with low-grade gliomas or nonglial tumors. The apparent water diffusivity was significantly greater in high-grade gliomas, whereas the anisotropy in these lesions was comparable to that of edema in other tumors. These findings indicated that water movement in areas of edema, predominantly in the extracellular spaces, was less restricted in high-grade gliomas, a phenomenon that likely reflected the destruction of the extracellular matrix ultrastructure by malignant cell infiltration and consequently greater water diffusion. Although preliminary, this study indicates that LCA could be used as a clinical tool for differentiating high-grade gliomas and for evaluating the extent of cellular infiltration.
KW - Diffusion tensor analysis
KW - Extracellular matrix
KW - Infiltration
KW - Lambda chart analysis
KW - Peritumoral edema
KW - Vasogenic edema
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U2 - 10.3171/jns.2005.102.2.0336
DO - 10.3171/jns.2005.102.2.0336
M3 - Article
C2 - 15739563
AN - SCOPUS:14844337540
VL - 102
SP - 336
EP - 341
JO - Journal of Neurosurgery
JF - Journal of Neurosurgery
SN - 0022-3085
IS - 2
ER -