The benefits of Apparent Diffusion Coefficient maps for high-grade glioma delineation

Název česky Přínos DWI pro vymezování hrani difúzně se šířících high-grade gliálních neoplázií
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JANČÁLEK Radim VALEKOVÁ Hana HENDRYCH Michal HERMANOVÁ Markéta MUSILOVÁ Barbora

Rok publikování 2019
Druh Konferenční abstrakty
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Popis Apparent diffusion coefficient (ADC) maps provide voxel-based measures of the mean water diffusivity. As increased cellularity leads to restriction of water molecule diffusion, ADC maps can have better ability to describe and delineate gliomas rather than a structural MRI. The aim of our project was to determine whether the histological features and boundary of high-grade gliomas (HGG) might be predicted on the basis of ADC values. Our cohort comprised 24 patients with HGG in which targeted biopsy based on conventional MRI were performed. Tumor tissue samples were collected separately from following regions: T1WI+, T2WI+, and regions of surgical approach T1WI-T2WI-. The samples underwent histopathological analysis for nestin, proliferation index Ki-67, and vascular density by expression of endothelial antigen CD31. The results of histopathological analysis were related to the corresponding findings on MRI, and the respective ADC was subtracted for each sample. The samples were stratified by expression of nestin into a tumor core, peritumoral brain zone (PBZ = HGG infiltrating zone) and tumor-free brain zone. We demonstrated a statistically significant (p< 0.05) relationship between the ADC value and the histological features of HGG. Increasing ADC in the vicinity of HGG was linked with decreasing cellularity, proliferation index Ki67 and vascular density. We have also shown statistically significant difference (p< 0.05) of the ADC values for the PBZ and the brain tissue with no histological sign of tumor infiltration. On the contrary, the characteristics based on the MRI regions were overlapping (p> 0.05). Reported findings suggest that the ADC value might be superior in specifying the boundary of histological infiltration of HGG to structural MRI. ADC imaging could be used for more accurate planning of surgical resection and radiation therapy in patients with diagnosis of HGG. This study was supported by the Grant Agency of Masaryk University: MUNI/A/1252/2017, and MUNI/A/1562/2018.
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