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01-05-2016 | Neuro

Evaluation of low-grade glioma structural changes after chemotherapy using DTI-based histogram analysis and functional diffusion maps

Authors: Antonella Castellano, Marina Donativi, Roberta Rudà, Giorgio De Nunzio, Marco Riva, Antonella Iadanza, Luca Bertero, Matteo Rucco, Lorenzo Bello, Riccardo Soffietti, Andrea Falini

Published in: European Radiology | Issue 5/2016

Abstract

Objectives

To explore the role of diffusion tensor imaging (DTI)-based histogram analysis and functional diffusion maps (fDMs) in evaluating structural changes of low-grade gliomas (LGGs) receiving temozolomide (TMZ) chemotherapy.

Methods

Twenty-one LGG patients underwent 3T-MR examinations before and after three and six cycles of dose-dense TMZ, including 3D-fluid-attenuated inversion recovery (FLAIR) sequences and DTI (b = 1000 s/mm², 32 directions). Mean diffusivity (MD), fractional anisotropy (FA), and tensor-decomposition DTI maps (p and q) were obtained. Histogram and fDM analyses were performed on co-registered baseline and post-chemotherapy maps. DTI changes were compared with modifications of tumour area and volume [according to Response Assessment in Neuro-Oncology (RANO) criteria], and seizure response.

Results

After three cycles of TMZ, 20/21 patients were stable according to RANO criteria, but DTI changes were observed in all patients (Wilcoxon test, P ≤ 0.03). After six cycles, DTI changes were more pronounced (P ≤ 0.005). Seventy-five percent of patients had early seizure response with significant improvement of DTI values, maintaining stability on FLAIR. Early changes of the 25th percentiles of p and MD predicted final volume change (R² = 0.614 and 0.561, P < 0.0005, respectively). TMZ-related changes were located mainly at tumour borders on p and MD fDMs.

Conclusions

DTI-based histogram and fDM analyses are useful techniques to evaluate the early effects of TMZ chemotherapy in LGG patients.

Key Points

• DTI helps to assess the efficacy of chemotherapy in low-grade gliomas.

• Histogram analysis of DTI metrics quantifies structural changes in tumour tissue.

• Functional diffusion maps (fDMs) spatially localize the changes of DTI metrics.

• Changes in DTI histograms and fDMs precede changes in conventional MRI.

• Early changes in DTI histograms and fDMs correlate with seizure response.

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Title: Evaluation of low-grade glioma structural changes after chemotherapy using DTI-based histogram analysis and functional diffusion maps
Authors: Antonella Castellano
Marina Donativi
Roberta Rudà
Giorgio De Nunzio
Marco Riva
Antonella Iadanza
Luca Bertero
Matteo Rucco
Lorenzo Bello
Riccardo Soffietti
Andrea Falini
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 5/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3934-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Evaluation of low-grade glioma structural changes after chemotherapy using DTI-based histogram analysis and functional diffusion maps

Abstract

Objectives

Methods

Results

Conclusions

Key Points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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