American Journal of Neuroradiology 25:201-209, February 2004
© 2004 American Society of Neuroradiology
BRAIN
Diffusion-Weighted Imaging in the Follow-up of Treated High-Grade Gliomas: Tumor Recurrence versus Radiation Injury
a Section of Radiation Oncology, Norris Cotton Cancer Center, Lebanon, NH
b Department of Radiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
Address reprint requests to Patrick A. Hein, MD, Department of Radiology, Charité, Humboldt Universitaet zu Berlin, Schumannstr. 20/21, 10098 Berlin, Germany
BACKGROUND AND PURPOSE: Diffusion-weighted (DW) MR imaging is a means to characterize and differentiate morphologic features, including edema, necrosis, and tumor tissue, by measuring differences in apparent diffusion coefficient (ADC). We hypothesized that DW imaging has the potential to differentiate recurrent or progressive tumor growth from treatment-induced damage to brain parenchyma in high-grade gliomas after radiation therapy.
METHODS: We retrospectively reviewed follow-up conventional and DW MR images obtained starting 1 month after completion of radiation treatment with or without chemotherapy for histologically proved high-grade gliomas. Eighteen patients with areas of abnormal enhancing tissue were identified. ADC maps were calculated from echo-planar DW images, and mean ADC values and ADC ratios (ADC of enhancing lesion to ADC of contralateral white matter) were compared with final diagnosis. Recurrence was established by histologic examination or by clinical course and a combination of imaging studies.
RESULTS: Recurrence and nonrecurrence could be differentiated by using mean ADC values and ADC ratios. ADC ratios in the recurrence group showed significantly lower values (mean ± SD, 1.43 ± 0.11) than those of the nonrecurrence group (1.82 ± 0.07, P < .001). Mean ADCs of the recurrent tumors (mean ± SD, 1.18 ± 0.13 x 10-3 mm/s2) were significantly lower than those of the nonrecurrence group (1.40 ± 0.17 x 10-3 mm/s2, P < .006).
CONCLUSION: Assessment of ADC ratios of enhancing regions in the follow-up of treated high-grade gliomas is useful in differentiating radiation effects from tumor recurrence or progression.
This article has been cited by other articles:
 |
|
 |
|
  M. E. P. Philippens, G. Gambarota, A. J. van der Kogel, and A. Heerschap Radiation Effects in the Rat Spinal Cord: Evaluation with Apparent Diffusion Coefficient versus T2 at Serial MR Imaging Radiology, November 26, 2008; (2008) 2502071374. [Abstract] [Full Text]
|
|
|
|
 |
|
 V.A. Nagar, J.R. Ye, W.H. Ng, Y.H. Chan, F. Hui, C.K. Lee, and C.C.T. Lim Diffusion-Weighted MR Imaging: Diagnosing Atypical or Malignant Meningiomas and Detecting Tumor Dedifferentiation AJNR Am. J. Neuroradiol., June 1, 2008; 29(6): 1147 - 1152. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.S. Seo, K.-H. Chang, D.G. Na, B.J. Kwon, and D.H. Lee High b-Value Diffusion (b = 3000 s/mm2) MR Imaging in Cerebral Gliomas at 3T: Visual and Quantitative Comparisons with b = 1000 s/mm2 AJNR Am. J. Neuroradiol., March 1, 2008; 29(3): 458 - 463. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Welzel, A. Niethammer, U. Mende, S. Heiland, F. Wenz, J. Debus, and R. Krempien Diffusion Tensor Imaging Screening of Radiation-Induced Changes in the White Matter after Prophylactic Cranial Irradiation of Patients with Small Cell Lung Cancer: First Results of a Prospective Study AJNR Am. J. Neuroradiol., February 1, 2008; 29(2): 379 - 383. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Torigian, S. S. Huang, M. Houseni, and A. Alavi Functional Imaging of Cancer with Emphasis on Molecular Techniques CA Cancer J Clin, July 1, 2007; 57(4): 206 - 224. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.A.K. A. Razek, A.Y. Kandeel, N. Soliman, H.M. El-shenshawy, Y. Kamel, N. Nada, and A. Denewar Role of Diffusion-Weighted Echo-Planar MR Imaging in Differentiation of Residual or Recurrent Head and Neck Tumors and Posttreatment Changes AJNR Am. J. Neuroradiol., June 1, 2007; 28(6): 1146 - 1152. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D.-M. Koh, E. Scurr, D. Collins, B. Kanber, A. Norman, M. O. Leach, and J. E. Husband Predicting Response of Colorectal Hepatic Metastasis: Value of Pretreatment Apparent Diffusion Coefficients Am. J. Roentgenol., April 1, 2007; 188(4): 1001 - 1008. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V Vandecaveye, F de Keyzer, V Vander Poorten, K Deraedt, H Alaerts, W Landuyt, S Nuyts, and R Hermans Evaluation of the larynx for tumour recurrence by diffusion-weighted MRI after radiotherapy: initial experience in four cases Br. J. Radiol., August 1, 2006; 79(944): 681 - 687. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G G Fan, Q L Deng, Z H Wu, and Q Y Guo Usefulness of diffusion/perfusion-weighted MRI in patients with non-enhancing supratentorial brain gliomas: a valuable tool to predict tumour grading? Br. J. Radiol., August 1, 2006; 79(944): 652 - 658. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Rumboldt, D.L.A. Camacho, D. Lake, C.T. Welsh, and M. Castillo Apparent Diffusion Coefficients for Differentiation of Cerebellar Tumors in Children AJNR Am. J. Neuroradiol., June 1, 2006; 27(6): 1362 - 1369. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Provenzale, S. Mukundan, and D. P. Barboriak Diffusion-weighted and Perfusion MR Imaging for Brain Tumor Characterization and Assessment of Treatment Response. Radiology, June 1, 2006; 239(3): 632 - 649. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. A. Butowski, P. K. Sneed, and S. M. Chang Diagnosis and Treatment of Recurrent High-Grade Astrocytoma J. Clin. Oncol., March 10, 2006; 24(8): 1273 - 1280. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Weybright, P. C. Sundgren, P. Maly, D. G. Hassan, B. Nan, S. Rohrer, and L. Junck Differentiation Between Brain Tumor Recurrence and Radiation Injury Using MR Spectroscopy Am. J. Roentgenol., December 1, 2005; 185(6): 1471 - 1476. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. Mullins, G. D. Barest, P. W. Schaefer, F. H. Hochberg, R. G. Gonzalez, and M. H. Lev Radiation Necrosis Versus Glioma Recurrence: Conventional MR Imaging Clues to Diagnosis AJNR Am. J. Neuroradiol., September 1, 2005; 26(8): 1967 - 1972. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Asao, Y. Korogi, M. Kitajima, T. Hirai, Y. Baba, K. Makino, M. Kochi, S. Morishita, and Y. Yamashita Diffusion-Weighted Imaging of Radiation-Induced Brain Injury for Differentiation from Tumor Recurrence AJNR Am. J. Neuroradiol., June 1, 2005; 26(6): 1455 - 1460. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W.-Y. Guo Is Current Imaging Good Enough to Differentiate Radiation-Induced Brain Injury from Tumor Recurrence? AJNR Am. J. Neuroradiol., June 1, 2005; 26(6): 1305 - 1305. [Full Text] [PDF]
|
|