Comparative Evaluation of Dynamic Contrast-Enhanced Perfusion With Diffusion Tensor Imaging Metrics in Assessment of Corticospinal Tract Infiltration in Malignant Glioma

Abstract

To compare dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) with diffusion tensor imaging (DTI) for predicting tumor infiltration in a conventional MRI normal-appearing internal capsule adjacent to the tumor in patients with glioblastoma multiforme. Thirty patients with glioblastoma multiforme underwent a neurological examination for motor assessment, DCE MRI, and DTI. On fused DCE and DTI images, regions of interest were placed on the normal-appearing internal capsule and the corresponding region of the contralateral internal capsule. These patients were pooled into group 1 (improved after surgery, n = 9) and group 2 (did not improve after surgery, n = 21) on the basis of motor strength. The DTI and perfusion metrics were statistically analyzed to look for a predictor of motor functionality. Multivariate logistic regression analysis showed only cerebral blood volume to be the predictor of improvement in motor functionality after surgery (P = 0.043). We conclude that cerebral blood volume appears to be the predictor of motor functionality after surgery and may indirectly suggest tumor infiltration, whereas DTI helps to precisely localize the fiber tracts.