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CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0045-1813221
Research Article

Role of Diffusion Tensor Imaging in Grading of Brain Tumors and Assessment of White Matter Tract Invasion

Autoren

  • Resham Singh 

    1   Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India

  • Shibani Mehra

    1   Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India

  • Bheru Dan Charan 

    2   Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, Uttarakhand, India
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Abstract

Background

Diffusion tensor imaging (DTI) is a novel advancement of nuclear magnetic resonance that provides an accurate, noninvasive evaluation of brain tumors and their orientation to the adjacent white matter tract. We sought to analyze DTI's role in grading brain tumors and determining white matter tract involvement.

Materials and Methods

DTI with the “ep2d_diff_mddw_20_(DTI)” sequence was done in 48 individuals with brain tumors (22 low-grade and 26 high-grade). The DTI measurements, including fractional anisotropy (FA) and apparent diffusion coefficient (ADC), were checked in the tumor itself, the tumor margin, and the area around the tumor. After comparing the results between the two groups, the cutoff was determined using the receiver operating characteristic curve. Tensor maps were obtained by tractography to observe white matter tract involvement.

Results

Mean FA values in the intratumoral region and tumor margins were substantially lower in high-grade than low-grade tumors (p-value < 0.05). FA values greater than 0.12 intratumorally (sensitivity = 69.23% and specificity = 63.64%) and 0.26 at the tumor margin (sensitivity = 65.38% and specificity = 68.18%) can distinguish low-grade from high-grade brain tumors. The two groups' FA values for peritumoral edema and ADC values in different places did not significantly differ. Displacement of tracts was significantly associated with low-grade tumors, while high-grade tumors showed significantly more degrees of disruption, tract infiltration, and tract edema (p-value < 0.001).

Conclusion

DTI is a modern and effective method for predicting tumor aggressiveness and tract involvement in the tumor's surroundings before surgery.

Keywords

brain - glioma - invasion - tract - tumor

Authors' Contributions

R.S. and S.M. contributed to the acquisition, analysis, conception, design, and drafting of the work. B.D.C. contributed to the final draft, revisions, upload, and submission of the final revised work. All authors have agreed to be personally accountable for their contributions and ensured that questions related to the accuracy or integrity of any part of the work, even those in which one was not personally involved, are appropriately investigated, resolved, and documented in the literature.


Ethical Approval

This work adhered to the principles outlined in the Declaration of Helsinki.




Publikationsverlauf

Artikel online veröffentlicht:
12. November 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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