Abstract
Purpose: Glioma cell infiltration, in which the glioma tumor cells spread long distances from the primary location using white matter (WM) or blood vessels, is known as a significant challenge for surgery or localized chemotherapy and radiation therapy. Following the World Health Organization (WHO), the glioma grading system ranges from stages I to IV, in which lower-grade gliomas represent benign tumors, and higher grade gliomas are considered the most malignant.Materials and Methods: We gathered magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) data for seven patients with right precentral gyrus-located tumors and six age- and sex-matched healthy subjects for analysis. Tract-Based Spatial Statistics (TBSS) was utilized to evaluate whole-brain WM implication due to probable tumor infiltration. Also, along-tract statistics were used in order to trace the implicated WM tracts. Finally, for cortical evaluation of probable tumor cell migration, voxel-based morphometry (VBM) was utilized, which allowed us to do whole-brain cortical estimation.Results: The TBSS results revealed significantly higher fractional anisotropy (FA) and lower mean diffusivity (MD) in the left side superior corona radiata. Also, higher FA was observed in the right corticostriatal tract. Along-tract statistics were also compiled on the corpus callosum (CC), which is anatomically known as a hub between hemispheres. The body of the CC, which connected with the superior corona radiata anatomically, showed significantly higher FA values relative to healthy subjects, which are in line with the TBSS results. Consistent with these results, whole-brain gray matter changes were analyzed via VBM, which showed significant hypertrophy of both sides of the brainstem.Conclusion: In future investigations, focusing on the genetic basis of the glioma patients in line with imaging studies on a larger sample size, which is known as genetics imaging, would be a suitable approach for tracing this process.
Highlights
Glioma invasion, as the major obstacle for curing patients, is hypothesized to be carried out via extracellular routes to the other brain structures, and causes significant complications for complete surgical resection and chemotherapy and radiation therapy.Glioma cell migration, which can occur over long distances via white matter (WM) or blood vessels to injure WM or cortical structures, has been investigated previously in mammalian brains (Cayre et al, 2009). Scherer (1938) investigated 100 patients with glioma tumors and created criteria for glioma invasion through the brain parenchyma, preexisting blood vessels, subarachnoid space, and WM tracts.Diffusion tensor imaging (DTI) is a modern technique that is sensitive to the diffusion of water flow along the WM tracts
Significant WM maturation occurred in patients vs. healthy controls, and the fractional anisotropy (FA) was significantly higher (P < 0.001) than the mean diffusivity (MD) in patients relative to healthy subjects; this result could be a reflection of probable WM maturation due to glioma tumor migration
The FA was significantly higher than the MD values (P < 0.001), which could be a sign of glioma migration along the corpus callosum (CC), which acts as a hub between both hemispheres
Summary
As the major obstacle for curing patients, is hypothesized to be carried out via extracellular routes to the other brain structures, and causes significant complications for complete surgical resection and chemotherapy and radiation therapy.Glioma cell migration, which can occur over long distances via white matter (WM) or blood vessels to injure WM or cortical structures, has been investigated previously in mammalian brains (Cayre et al, 2009). Scherer (1938) investigated 100 patients with glioma tumors and created criteria for glioma invasion through the brain parenchyma, preexisting blood vessels, subarachnoid space, and WM tracts.Diffusion tensor imaging (DTI) is a modern technique that is sensitive to the diffusion of water flow along the WM tracts. Glioma cell migration, which can occur over long distances via white matter (WM) or blood vessels to injure WM or cortical structures, has been investigated previously in mammalian brains (Cayre et al, 2009). Scherer (1938) investigated 100 patients with glioma tumors and created criteria for glioma invasion through the brain parenchyma, preexisting blood vessels, subarachnoid space, and WM tracts. Diffusion tensor imaging (DTI) is a modern technique that is sensitive to the diffusion of water flow along the WM tracts. It can detect tumor infiltration through the WM tracts when conventional magnetic resonance imaging (MRI) scans appear to be normal (Price et al, 2003). The infiltrating glioma cells extend beyond a surgeon’s reach, which can limit the effectiveness of localized therapy (Hochberg and Pruitt, 1980; Burger et al, 1988; Kreth et al, 1993; Shapiro, 1999)
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