Subventricular Zone Involvement Characterized by Diffusion Tensor Imaging in Glioblastoma.
van Dijken, Bart RJ
van Laar, Peter Jan
van der Hoorn, Anouk
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van Dijken, B. R., Yan, J., Boonzaier, N. R., Li, C., van Laar, P. J., van der Hoorn, A., & Price, S. (2017). Subventricular Zone Involvement Characterized by Diffusion Tensor Imaging in Glioblastoma.. World neurosurgery, 105 697-701. https://doi.org/10.1016/j.wneu.2017.06.075
Background Glioblastomas have a poor prognosis, possibly due to a subpopulation of therapy resistant stem cells within the heterogeneous glioblastoma. As the subventricular zone is the main source of neural stem cells, we aimed at characterising the subventricular zone using DTI to demonstrate subventricular zone involvement in glioblastoma. Methods We prospectively included 93 patients with primary glioblastomas who underwent preoperative DTI. The non-enhancing high FLAIR signal was used to describe the infiltrative tumour margin. We used a 5 mm margin surrounding the lateral ventricles to define the subventricular zone. The subventricular zone with high FLAIR was compared with the subventricular zone without high FLAIR, control high FLAIR outside the subventricular zone and control contralateral normal appearing white matter. Normalised DTI parameters were calculated and compared between the different regions. Results The subventricular zone with high FLAIR showed elevated isotropic p values compared to the subventricular zone without high FLAIR (t(126)=3.9, p<0.001) and control regions (t(179)=1.9, p=0.046). Anisotropic q and fractional anisotropy values were lower in regions with high FLAIR compared to the subventricular zone without high FLAIR (t(181)=11.6, p<0.001 and t(184)=12.4, p<0.001, respectively). Conclusion DTI data showed that the subventricular zone is involved in glioblastoma with elevated isotropic p values in the subventricular zone with high FLAIR, indicating tumour infiltration.
Lateral Ventricles, Humans, Glioblastoma, Brain Neoplasms, Prospective Studies, Adult, Aged, Middle Aged, Female, Male, Young Adult, Diffusion Tensor Imaging
This study was funded by a National Institute of Health Clinician Scientist Fellowship (S.P.), the Groningen University Fund (B.D.), the Marco Polo fund (B.D.), and grants from the Chang Gung Medical Foundation and Chang Gung Memorial Hospital, Keelung, Taiwan (J.Y.). The authors declare to have no conflicts of interest. This article presents independent research funded by the United Kingdom National Institute for Health Research. The views expressed are those of the author(s) and are not necessarily those of the United Kingdom National Health Service, the United Kingdom National Institute for Health Research, or the United Kingdom Department of Health.
External DOI: https://doi.org/10.1016/j.wneu.2017.06.075
This record's URL: https://www.repository.cam.ac.uk/handle/1810/266939
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