Evaluation of low-grade glioma structural changes after chemotherapy using DTI-based histogram analysis and functional diffusion maps

Antonella Castellano, Marina Donativi, Roberta Rudà, Giorgio De Nunzio, Marco Riva, Antonella Iadanza, Luca Bertero, Matteo Rucco, Lorenzo Bello, Riccardo Soffietti, Andrea Falini

Research output: Contribution to journalArticle

Abstract

Objectives: To explore the role of diffusion tensor imaging (DTI)-based histogram analysis and functional diffusion maps (fDMs) in evaluating structural changes of low-grade gliomas (LGGs) receiving temozolomide (TMZ) chemotherapy. Methods: Twenty-one LGG patients underwent 3T-MR examinations before and after three and six cycles of dose-dense TMZ, including 3D-fluid-attenuated inversion recovery (FLAIR) sequences and DTI (b = 1000 s/mm2, 32 directions). Mean diffusivity (MD), fractional anisotropy (FA), and tensor-decomposition DTI maps (p and q) were obtained. Histogram and fDM analyses were performed on co-registered baseline and post-chemotherapy maps. DTI changes were compared with modifications of tumour area and volume [according to Response Assessment in Neuro-Oncology (RANO) criteria], and seizure response. Results: After three cycles of TMZ, 20/21 patients were stable according to RANO criteria, but DTI changes were observed in all patients (Wilcoxon test, P ≤ 0.03). After six cycles, DTI changes were more pronounced (P ≤ 0.005). Seventy-five percent of patients had early seizure response with significant improvement of DTI values, maintaining stability on FLAIR. Early changes of the 25th percentiles of p and MD predicted final volume change (R2 = 0.614 and 0.561, P <0.0005, respectively). TMZ-related changes were located mainly at tumour borders on p and MD fDMs. Conclusions: DTI-based histogram and fDM analyses are useful techniques to evaluate the early effects of TMZ chemotherapy in LGG patients. Key Points: • DTI helps to assess the efficacy of chemotherapy in low-grade gliomas. • Histogram analysis of DTI metrics quantifies structural changes in tumour tissue. • Functional diffusion maps (fDMs) spatially localize the changes of DTI metrics. • Changes in DTI histograms and fDMs precede changes in conventional MRI. • Early changes in DTI histograms and fDMs correlate with seizure response.
Original languageEnglish
Pages (from-to)1263 - 1273
Number of pages11
JournalEuropean Radiology
Volume26
Issue number5
DOIs
Publication statusPublished - May 1 2016

Fingerprint

Diffusion Tensor Imaging
Glioma
temozolomide
Drug Therapy
Seizures
Sequence Inversion
Anisotropy
Tumor Burden
Neoplasms

Keywords

  • Chemotherapy
  • Diffusion Tensor Imaging
  • Glioma
  • Magnetic Resonance Imaging
  • Response Evaluation Criteria

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Evaluation of low-grade glioma structural changes after chemotherapy using DTI-based histogram analysis and functional diffusion maps. / Castellano, Antonella; Donativi, Marina; Rudà, Roberta; De Nunzio, Giorgio; Riva, Marco; Iadanza, Antonella; Bertero, Luca; Rucco, Matteo; Bello, Lorenzo; Soffietti, Riccardo; Falini, Andrea.

In: European Radiology, Vol. 26, No. 5, 01.05.2016, p. 1263 - 1273.

Research output: Contribution to journalArticle

Castellano, Antonella ; Donativi, Marina ; Rudà, Roberta ; De Nunzio, Giorgio ; Riva, Marco ; Iadanza, Antonella ; Bertero, Luca ; Rucco, Matteo ; Bello, Lorenzo ; Soffietti, Riccardo ; Falini, Andrea. / Evaluation of low-grade glioma structural changes after chemotherapy using DTI-based histogram analysis and functional diffusion maps. In: European Radiology. 2016 ; Vol. 26, No. 5. pp. 1263 - 1273.
@article{c999a9da4b9242fb83fe52787ef7ef71,
title = "Evaluation of low-grade glioma structural changes after chemotherapy using DTI-based histogram analysis and functional diffusion maps",
abstract = "Objectives: To explore the role of diffusion tensor imaging (DTI)-based histogram analysis and functional diffusion maps (fDMs) in evaluating structural changes of low-grade gliomas (LGGs) receiving temozolomide (TMZ) chemotherapy. Methods: Twenty-one LGG patients underwent 3T-MR examinations before and after three and six cycles of dose-dense TMZ, including 3D-fluid-attenuated inversion recovery (FLAIR) sequences and DTI (b = 1000 s/mm2, 32 directions). Mean diffusivity (MD), fractional anisotropy (FA), and tensor-decomposition DTI maps (p and q) were obtained. Histogram and fDM analyses were performed on co-registered baseline and post-chemotherapy maps. DTI changes were compared with modifications of tumour area and volume [according to Response Assessment in Neuro-Oncology (RANO) criteria], and seizure response. Results: After three cycles of TMZ, 20/21 patients were stable according to RANO criteria, but DTI changes were observed in all patients (Wilcoxon test, P ≤ 0.03). After six cycles, DTI changes were more pronounced (P ≤ 0.005). Seventy-five percent of patients had early seizure response with significant improvement of DTI values, maintaining stability on FLAIR. Early changes of the 25th percentiles of p and MD predicted final volume change (R2 = 0.614 and 0.561, P <0.0005, respectively). TMZ-related changes were located mainly at tumour borders on p and MD fDMs. Conclusions: DTI-based histogram and fDM analyses are useful techniques to evaluate the early effects of TMZ chemotherapy in LGG patients. Key Points: • DTI helps to assess the efficacy of chemotherapy in low-grade gliomas. • Histogram analysis of DTI metrics quantifies structural changes in tumour tissue. • Functional diffusion maps (fDMs) spatially localize the changes of DTI metrics. • Changes in DTI histograms and fDMs precede changes in conventional MRI. • Early changes in DTI histograms and fDMs correlate with seizure response.",
keywords = "Chemotherapy, Diffusion Tensor Imaging, Glioma, Magnetic Resonance Imaging, Response Evaluation Criteria",
author = "Antonella Castellano and Marina Donativi and Roberta Rud{\`a} and {De Nunzio}, Giorgio and Marco Riva and Antonella Iadanza and Luca Bertero and Matteo Rucco and Lorenzo Bello and Riccardo Soffietti and Andrea Falini",
year = "2016",
month = "5",
day = "1",
doi = "10.1007/s00330-015-3934-6",
language = "English",
volume = "26",
pages = "1263 -- 1273",
journal = "European Radiology",
issn = "0938-7994",
publisher = "Springer Verlag",
number = "5",

}

TY - JOUR

T1 - Evaluation of low-grade glioma structural changes after chemotherapy using DTI-based histogram analysis and functional diffusion maps

AU - Castellano, Antonella

AU - Donativi, Marina

AU - Rudà, Roberta

AU - De Nunzio, Giorgio

AU - Riva, Marco

AU - Iadanza, Antonella

AU - Bertero, Luca

AU - Rucco, Matteo

AU - Bello, Lorenzo

AU - Soffietti, Riccardo

AU - Falini, Andrea

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Objectives: To explore the role of diffusion tensor imaging (DTI)-based histogram analysis and functional diffusion maps (fDMs) in evaluating structural changes of low-grade gliomas (LGGs) receiving temozolomide (TMZ) chemotherapy. Methods: Twenty-one LGG patients underwent 3T-MR examinations before and after three and six cycles of dose-dense TMZ, including 3D-fluid-attenuated inversion recovery (FLAIR) sequences and DTI (b = 1000 s/mm2, 32 directions). Mean diffusivity (MD), fractional anisotropy (FA), and tensor-decomposition DTI maps (p and q) were obtained. Histogram and fDM analyses were performed on co-registered baseline and post-chemotherapy maps. DTI changes were compared with modifications of tumour area and volume [according to Response Assessment in Neuro-Oncology (RANO) criteria], and seizure response. Results: After three cycles of TMZ, 20/21 patients were stable according to RANO criteria, but DTI changes were observed in all patients (Wilcoxon test, P ≤ 0.03). After six cycles, DTI changes were more pronounced (P ≤ 0.005). Seventy-five percent of patients had early seizure response with significant improvement of DTI values, maintaining stability on FLAIR. Early changes of the 25th percentiles of p and MD predicted final volume change (R2 = 0.614 and 0.561, P <0.0005, respectively). TMZ-related changes were located mainly at tumour borders on p and MD fDMs. Conclusions: DTI-based histogram and fDM analyses are useful techniques to evaluate the early effects of TMZ chemotherapy in LGG patients. Key Points: • DTI helps to assess the efficacy of chemotherapy in low-grade gliomas. • Histogram analysis of DTI metrics quantifies structural changes in tumour tissue. • Functional diffusion maps (fDMs) spatially localize the changes of DTI metrics. • Changes in DTI histograms and fDMs precede changes in conventional MRI. • Early changes in DTI histograms and fDMs correlate with seizure response.

AB - Objectives: To explore the role of diffusion tensor imaging (DTI)-based histogram analysis and functional diffusion maps (fDMs) in evaluating structural changes of low-grade gliomas (LGGs) receiving temozolomide (TMZ) chemotherapy. Methods: Twenty-one LGG patients underwent 3T-MR examinations before and after three and six cycles of dose-dense TMZ, including 3D-fluid-attenuated inversion recovery (FLAIR) sequences and DTI (b = 1000 s/mm2, 32 directions). Mean diffusivity (MD), fractional anisotropy (FA), and tensor-decomposition DTI maps (p and q) were obtained. Histogram and fDM analyses were performed on co-registered baseline and post-chemotherapy maps. DTI changes were compared with modifications of tumour area and volume [according to Response Assessment in Neuro-Oncology (RANO) criteria], and seizure response. Results: After three cycles of TMZ, 20/21 patients were stable according to RANO criteria, but DTI changes were observed in all patients (Wilcoxon test, P ≤ 0.03). After six cycles, DTI changes were more pronounced (P ≤ 0.005). Seventy-five percent of patients had early seizure response with significant improvement of DTI values, maintaining stability on FLAIR. Early changes of the 25th percentiles of p and MD predicted final volume change (R2 = 0.614 and 0.561, P <0.0005, respectively). TMZ-related changes were located mainly at tumour borders on p and MD fDMs. Conclusions: DTI-based histogram and fDM analyses are useful techniques to evaluate the early effects of TMZ chemotherapy in LGG patients. Key Points: • DTI helps to assess the efficacy of chemotherapy in low-grade gliomas. • Histogram analysis of DTI metrics quantifies structural changes in tumour tissue. • Functional diffusion maps (fDMs) spatially localize the changes of DTI metrics. • Changes in DTI histograms and fDMs precede changes in conventional MRI. • Early changes in DTI histograms and fDMs correlate with seizure response.

KW - Chemotherapy

KW - Diffusion Tensor Imaging

KW - Glioma

KW - Magnetic Resonance Imaging

KW - Response Evaluation Criteria

UR - http://www.scopus.com/inward/record.url?scp=84941360846&amp;partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84941360846&amp;partnerID=8YFLogxK

U2 - 10.1007/s00330-015-3934-6

DO - 10.1007/s00330-015-3934-6

M3 - Article

VL - 26

SP - 1263

EP - 1273

JO - European Radiology

JF - European Radiology

SN - 0938-7994

IS - 5

ER -