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Linda Knutsson

Professor

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Separating Glioma Hyperintensities From White Matter by Diffusion-Weighted Imaging With Spherical Tensor Encoding

Författare

  • Jan Brabec
  • Faris Durmo
  • Filip Szczepankiewicz
  • Patrik Brynolfsson
  • Björn Lampinen
  • Anna Rydelius
  • Linda Knutsson
  • Carl-Fredrik Westin
  • Pia C Sundgren
  • Markus Nilsson

Summary, in English

Background: Tumor-related hyperintensities in high b-value diffusion-weighted imaging (DWI) are radiologically important in the workup of gliomas. However, the white matter may also appear as hyperintense, which may conflate interpretation.

Purpose: To investigate whether DWI with spherical b-tensor encoding (STE) can be used to suppress white matter and enhance the conspicuity of glioma hyperintensities unrelated to white matter.

Materials and Methods: Twenty-five patients with a glioma tumor and at least one pathology-related hyperintensity on DWI underwent conventional MRI at 3 T. The DWI was performed both with linear and spherical tensor encoding (LTE-DWI and STE-DWI). The LTE-DWI here refers to the DWI obtained with conventional diffusion encoding and averaged across diffusion-encoding directions. Retrospectively, the differences in contrast between LTE-DWI and STE-DWI, obtained at a b-value of 2,000 s/mm2, were evaluated by comparing hyperintensities and contralateral normal-appearing white matter (NAWM) both visually and quantitatively in terms of the signal intensity ratio (SIR) and contrast-to-noise ratio efficiency (CNReff).

Results: The spherical tensor encoding DWI was more effective than LTE-DWI at suppressing signals from white matter and improved conspicuity of pathology-related hyperintensities. The median SIR improved in all cases and on average by 28%. The median (interquartile range) SIR was 1.9 (1.6 - 2.1) for STE and 1.4 (1.3 - 1.7) for LTE, with a significant difference of 0.4 (0.3 -0.5) (p < 10-4, paired U-test). In 40% of the patients, the SIR was above 2 for STE-DWI, but with LTE-DWI, the SIR was below 2 for all patients. The CNReff of STE-DWI was significantly higher than of LTE-DWI: 2.5 (2 - 3.5) vs. 2.3 (1.7 - 3.1), with a significant difference of 0.4 (-0.1 -0.6) (p < 10-3, paired U-test). The STE improved CNReff in 70% of the cases. We illustrate the benefits of STE-DWI in three patients, where STE-DWI may facilitate an improved radiological description of tumor-related hyperintensity, including one case that could have been missed out if only LTE-DWI was inspected.

Conclusion: The contrast mechanism of high b-value STE-DWI results in a stronger suppression of white matter than conventional LTE-DWI, and may, therefore, be more sensitive and specific for assessment of glioma tumors and DWI-hyperintensities.

Avdelning/ar

  • Medicinsk strålningsfysik, Lund
  • MR Physics
  • Diagnostisk radiologi, Lund
  • Multidimensional microstructure imaging
  • Medicinsk strålningsfysik, Malmö
  • Neuroradiologi
  • MultiPark: Multidisciplinary research focused on Parkinson´s disease
  • Lund University Bioimaging Center
  • eSSENCE: The e-Science Collaboration

Publiceringsår

2022

Språk

Engelska

Publikation/Tidskrift/Serie

Frontiers in Neuroscience

Volym

16

Dokumenttyp

Artikel i tidskrift

Förlag

Frontiers Media S. A.

Ämne

  • Other Physics Topics
  • Radiology, Nuclear Medicine and Medical Imaging

Status

Published

Forskningsgrupp

  • MR Physics
  • Multidimensional microstructure imaging
  • Medical Radiation Physics, Malmö
  • Neuroradiology

ISBN/ISSN/Övrigt

  • ISSN: 1662-4548