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Preserved structural integrity of white matter adjacent to low-grade tumors

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Abstract

Background and purpose

Brain tumors may dislocate, infiltrate, or disrupt the adjacent fiber tracts. We examined (1) microstructural changes of white matter (WM) adjacent to supratentorial low grade tumors in children and (2) WM tracts of the affected hemisphere using diffusion tensor imaging (DTI). We hypothesized that the structural integrity of the adjacent WM tracts would be preserved in these slow-growing tumors.

Materials and methods

DTI was performed in 11 children with low grade tumors diagnosed by magnetic resonance imaging (MRI). Regions of interest were placed in the tumor, in WM adjacent to tumor, and on the normal contralateral side. Fractional anisotropy (FA), trace, and eigenvalues were measured. Color-coded maps and tractography were used to grade the WM tracts: Grade one was normal tract size and color hue; grade two was reduced tract size but preserved color hue; and grade three was loss of color hue or failure to track on tractography. Grades one and two were subcategorized as “a” or “b,” depending on the absence or presence of tract displacement.

Results

There were no significant differences in FA, trace, and eigenvalues between WM adjacent to tumor and the contralateral side. One patient had grade 1a changes, six grade 1b, and four grade 2b.

Conclusion

We found preserved microstructural integrity of WM adjacent to low grade tumors in children. Color vector maps and tractography demonstrated displacement of the WM tracts in all but one patient. Our findings could be useful for neurosurgical planning to minimize injury to the WM tracts and improve preoperative risk analysis.

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Acknowledgements

DN was supported by grants from the Swedish Epilepsy Society and the Göteborg Medical Society. This work was supported by the University of Toronto Research and Development Award. DTIStudio software was kindly provided by Drs. Hangyi Jiang and Susumi Mori.

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Authors and Affiliations

  1. Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada

    Daniel Nilsson, Charles R. Raybaud & Elysa Widjaja

  2. Division of Neurosurgery, The Hospital for Sick Children, Toronto, ON, Canada

    James T. Rutka

  3. Department of Neurology, The Hospital for Sick Children, Toronto, ON, Canada

    O. Carter Snead III

  4. Institute of Neuroscience and Physiology, Epilepsy Research Group, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden

    Daniel Nilsson

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  1. Daniel Nilsson
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  2. James T. Rutka
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  3. O. Carter Snead III
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  5. Elysa Widjaja
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Correspondence to Elysa Widjaja.

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Nilsson, D., Rutka, J.T., Snead, O.C. et al. Preserved structural integrity of white matter adjacent to low-grade tumors. Childs Nerv Syst 24, 313–320 (2008). https://doi.org/10.1007/s00381-007-0466-7

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  • DOI: https://doi.org/10.1007/s00381-007-0466-7

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