DTI assessment of the brainstem white matter tracts in pediatric BSG before and after therapy: a report from the Pediatric Brain Tumor Consortium.
DTI assessment of the brainstem white matter tracts in pediatric BSG before and after therapy: a report from the Pediatric Brain Tumor Consortium.
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DOI：
10.1007/s00381-010-1323-7
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发表时间：
2011-01
期刊：
影响因子：
--
通讯作者：
Poussaint TY
中科院分区：
文献类型：
--
作者：
Prabhu SP;Ng S;Vajapeyam S;Kieran MW;Pollack IF;Geyer R;Haas-Kogan D;Boyett JM;Kun L;Poussaint TY
目的应用扩散张量成像（DTI）技术评价儿童脑干胶质瘤的表观扩散系数（ADC）和各向异性分数（FA）值的变化，并观察治疗后白色物质束变化的时间演变。在3例新诊断的脑干胶质瘤患者中，采用两种批准的治疗方案获得了系列ADC和FA测量值。将这些值与一组年龄匹配的儿童皮质脊髓束、桥脑横束和内侧丘系束的标准ADC、FA和特征值进行比较。使用标准扩散纤维束成像分析进行了通过脑干的纤维束追踪。我们发现，与年龄匹配的对照组相比，基线时肿瘤内的ADC值增加，治疗后ADC值随后下降，复发后ADC值随后增加。相应地，FA值在就诊时降低，但在肿瘤对治疗的反应阶段短暂恢复，最终在肿瘤进展期间显著降低。这些变化与脑干中白色物质束的纤维束成像分析一致。基于这些结果，我们认为ADC和FA值的初始变化反映了肿瘤的道浸润，但不是完全破坏，而肿瘤进展导致各向异性的完全丧失可能是由于道破坏。儿童脑干胶质瘤的ADC和FA值以及纤维束成像数据的一系列变化表明最初的肿瘤浸润，治疗后出现短暂改善，随后在肿瘤进展过程中纤维束各向异性丧失。该技术可能在评估儿童脑干胶质瘤治疗方案的反应中具有潜在的用途。
To assess changes in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values in brainstem gliomas in children and to observe the temporal evolution of changes in the white matter tracts following therapy using diffusion tensor imaging (DTI) analysis. Serial ADC and FA measurements were obtained in 3 patients with newly diagnosed brainstem gliomas on two approved treatment protocols. Values were compared with a set of normative ADC, FA, and eigenvalues of age-matched children of the corticospinal, transverse pontine and medial lemniscal tracts. Fiber tracking of the tracts coursing through the brainstem was performed using standard diffusion tractography analysis. We found increased ADC values within tumor at baseline compared to age-matched controls, with subsequent drop following treatment and subsequent increase with recurrence. Correspondingly, FA values were reduced at presentation, but transiently recovered during the phase of tumor response to treatment, and finally decreased significantly during tumor progression. These changes were concordant with the tractography analysis of white matter tracts in the brainstem. Based on these results, we suggest that initial changes in ADC and FA values reflects tract infiltration by tumor, but not complete disruption, whereas tumor progression results in complete loss of anisotropy possibly due to tract disruption. Serial changes in ADC and FA values and tractography data in pediatric brainstem gliomas suggest initial tumor infiltration, with transient improvement on treatment and subsequent loss of tract anisotropy during tumor progression. This technique may have potential use in assessing response to treatment regimens for pediatric brainstem gliomas.
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影响因子：
5.7
作者：
Stieltjes, B;Kaufmann, WE;Mori, S
通讯作者：
Mori, S
影响因子：
5.8
作者：
Broniscer, A;Gajjar, A
通讯作者：
Gajjar, A
影响因子：
4.1
作者：
Phillips, NS;Sanford, RA;Ogg, RJ
通讯作者：
Ogg, RJ
影响因子：
45.3
作者：
Chan, JL;Lee, SW;Sandler, HM
通讯作者：
Sandler, HM
影响因子：
15.9
作者：
Haas-Kogan, Daphne A.;Banerjee, Anuradha;Kun, Larry E.
通讯作者：
Kun, Larry E.