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Evaluation of Multimodal Mr Imaging for Differentiating Infiltrative Versus Reactive Edema in Brain Gliomas Publisher Pubmed

Summary: Can MRI help delineate brain tumor borders? Research finds that it may miss tumors disguised as edema but can identify infiltrative edges effectively. #NeuroImaging #BrainTumors

Amjad G1 ; Zeinali Zadeh M2 ; Azmoudehardalan F3 ; Jalali AH4 ; Shakiba M4 ; Ghavami N4 ; Oghabian Z5 ; Oghabian MA5 ; Firouznia S6 ; Rafiei B7 ; Sabet Rasekh P4 ; Tahmasebi Arashloo F8 ; Firouznia K4
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Source: British Journal of Neurosurgery Published:2023


Abstract

Objective: To determine the border of glial tumors by diffusion weighted imaging (DWI), apparent diffusion co-efficient (ADC), magnetic resonance spectroscopy (MRS) and perfusion brain MRI. Patients and methods: Ten patients with brain gliomas were enrolled [mean age: 35.3 ± 13.2, range: 20–62]. Conventional MRI was performed for all patients. Besides, tumor mapping based on Choline (Cho)/Creatine (Cr) color map in MRS, perfusion and diffusion color maps, were gathered. Different tumoral and peritumoral regions [normal tissue, reactive edema, infiltrative edema, and tumor core] were defined. MRI criteria were evaluated in areas targeted for biopsy and histopathologic evaluation was determined. Results: Tumor cell positive samples [one necrosis, 26 infiltrative and nine tumor cores] composed 36 (75%) of the 48 samples. Seven (19.4%) of the positive samples were interpreted as not tumor on MRI. Five were identified as reactive edema and two as normal tissue] [kappa:.67, p-value <.001]. Mean of ADC, median of N-acetylaspartate (NAA) and NAA/Cho were statistically different between positive and negative samples (p =.02 and p <.001, respectively). Mean ADC and median Cho/NAA were statistically different in missed tumor containing tissue presented as reactive edema compared to normal and correctly diagnosed reactive edema samples together (p-values <.05). Conclusions: Multimodal MRI could define infiltrated borders of brain gliomas. © 2020 The Neurosurgical Foundation.
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