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Neuro Oncol. 2014 Mar;16(3):449-56. doi: 10.1093/neuonc/not197. Epub 2013 Dec 4.

Challenges for the functional diffusion map in pediatric brain tumors.

Author information

1
Imaging and Biophysics Unit, UCL Institute of Child Health, University College London, London, UK (M.G-S., J.D.C., C.A.C.); Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK (D.E.S.); Department of Neuro-oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London UK (K.P.P.); Neural Development Unit, Birth Defects Research Centre, UCL Institute of Child Health, University College London, London, UK (S.M.L.P., T.S.J.); Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK (S.M.L.P., T.S.J.).

Abstract

BACKGROUND:

The functional diffusion map (fDM) has been suggested as a tool for early detection of tumor treatment efficacy. We aim to study 3 factors that could act as potential confounders in the fDM: areas of necrosis, tumor grade, and change in tumor size.

METHODS:

Thirty-four pediatric patients with brain tumors were enrolled in a retrospective study, approved by the local ethics committee, to examine the fDM. Tumors were selected to encompass a range of types and grades. A qualitative analysis was carried out to compare how fDM findings may be affected by each of the 3 confounders by comparing fDM findings to clinical image reports.

RESULTS:

Results show that the fDM in areas of necrosis do not discriminate between treatment response and tumor progression. Furthermore, tumor grade alters the behavior of the fDM: a decrease in apparent diffusion coefficient (ADC) is a sign of tumor progression in high-grade tumors and treatment response in low-grade tumors. Our results also suggest using only tumor area overlap between the 2 time points analyzed for the fDM in tumors of varying size.

CONCLUSIONS:

Interpretation of fDM results needs to take into account the underlying biology of both tumor and healthy tissue. Careful interpretation of the results is required with due consideration to areas of necrosis, tumor grade, and change in tumor size.

KEYWORDS:

apparent diffusion coefficient; childhood tumors; diffusion-weighted magnetic resonance imaging; functional diffusion map; parametric response map

PMID:
24305721
PMCID:
PMC3922510
DOI:
10.1093/neuonc/not197
[Indexed for MEDLINE]
Free PMC Article
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