Wilhelm Harald Flatz MD, Presenter: Nothing to Disclose

Olaf Dietrich, Abstract Co-Author: Nothing to Disclose

Stefan Oswald Schoenberg MD, PhD, Abstract Co-Author: Nothing to Disclose

Birgit Betina Ertl-Wagner MD, Abstract Co-Author: Nothing to Disclose

Christian Glaser MD, Abstract Co-Author: Nothing to Disclose

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

The objective of our study was to detect and evaluate intra- and peritumoral mean diffusivity and fractional anisotropy to differentiate between high grade gliomas and brain metastases.

22 previously untreated patients suffering from histologically proven high grade glioma and 17 patients diagnosed with brain metastases from mammary cancer were examined in our study. MRI was performed using a 3 T scanner acquiring DTI images with 12 directions. The regions of interest (ROI) were positioned for DTI evaluation were positioned into different parts of the tumor (center, border), on the vasogenic edema surrounding the tumor depicted by abnormal T2-weighted images and on normal appearing white matter.

Significant decrease of fractional anisotropy (FA) (p<0.005) and significant increase of mean diffusivity (MD) (p<0.005) was found in the peritumoral regions compared to normal appearing white matter. For brain metastases the peritumoral MD was significantely increased compared to high-grade gliomas (p<0.01). Peritumoral FA and FA in the tumor border showed no significant differences comparing the two patient groups.

Due to increased extracellular water, diffusion parameters show a pathological change within peritumoral vasogenic edema in both high-grade gliomas and tumor metastases. Unlike FA, MD can be used to differentiate between high-grade gliomas and metastatic tumors, pointing towards probable tumor infiltration characterized by MD-values.

DTI of high-grade gliomas and brain metastases may help in differentiating between high grade glioma and brain metastases.

Flatz, W, Dietrich, O, Schoenberg, S, Ertl-Wagner, B, Glaser, C, Reiser, M, Diffusion Tensor Imaging of High Grade Gliomas and Brain Metastases.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8011467.html