Metabolite ratios to assumed stable creatine level may confound the quantification of proton brain MR spectroscopy

In localized brain proton MR spectroscopy ((1)H-MRS), metabolites' levels are often expressed as ratios, rather than as absolute concentrations. Frequently, their denominator is the creatine [Cr], which level is explicitly assumed to be stable in normal as well as in many pathologic states. The rationale is that ratios self-correct for imager and localization method differences, gain instabilities, regional susceptibility variations and partial volume effects. The implicit assumption is that these benefits are worth their cost(w)-(w) propagation of the individual variation of each of the ratio's components. To test this hypothesis, absolute levels of N-acetylaspartate [NAA], choline [Cho] and [Cr] were quantified in various regions of the brains of 8 volunteers, using 3-dimensional (3D) (1)H-MRS at 1.5 T. The results show that in over 50% of approximately 2000 voxels examined, [NAA]/[Cr] and [Cho]/[Cr] exhibited higher coefficients of variations (CV) than [NAA] and [Cho] individually. Furthermore, in approximately 33% of these voxels, the ratios' CVs exceeded even the combined constituents' CVs. Consequently, basing metabolite quantification on ratios and assuming stable [Cr] introduces more variability into (1)H-MRS than it prevents. Therefore, its cost exceeds the benefit.     

Correlation between metabolite ratios and ADC values of prostate in men with increased PSA level

Proton magnetic resonance spectroscopic imaging (MRSI) and diffusion-weighted imaging (DWI) were carried out in men with increased prostate-specific antigen (PSA) level. Forty subjects [controls (Group I) and patients (Groups II and III with PSA >20 and 4-20 ng/ml, respectively)] were investigated using endorectal coil at 1.5 T prior to transrectal ultrasound (TRUS)-guided biopsy. Metabolite ratio [citrate/(choline+creatine)] and apparent diffusion coefficient (ADC) were calculated for identical voxels. In patients, voxels that showed lower metabolite ratio showed reduced ADC in the peripheral zone (PZ) of the prostate, and voxels with increased metabolite ratio showed higher ADC. Metabolite ratios were used to predict areas of malignancy if the ratio was <1.4 and if ADC value was <1.17 x 10(-3) mm(2)/s. Patients in Group II had lower metabolite ratio and ADC in the PZ compared to controls and Group III. All 13 were positive for malignancy in MR, while 12 of 13 were positive on TRUS-guided sextant biopsy. In Group III, certain voxels of PZ that showed reduced metabolite ratio also showed lower ADC. A positive correlation was observed between metabolite ratio and ADC. MR predicted areas of malignancy in PZ in 15 of 20 patients; however, only six were positive on TRUS-guided biopsy perhaps due to high false-negative rate of TRUS-guided biopsy. Results show positive correlation between MRSI and DWI and their potential in detection of malignancy, thereby improving the diagnosis especially in patients with PSA level of 4-20 ng/ml.     

Lesion T(2) relaxation times and volumes predict the response of malignant breast lesions to neoadjuvant chemotherapy

The aim of this study was to investigate the utility of the water T(2) values of malignant breast lesions in predicting response after the first and second cycles of neoadjuvant chemotherapy (NAC), both alone and in combination with lesion volumes. Thirty-five patients were scanned before the commencement of chemotherapy and again after the first, second and final treatment cycles. Two methods of obtaining lesion T(2) were used: imaging, where a series of T(2)-weighted images was acquired (T(R)/T(E)=1000/30, 60, 90 and 120 ms), and spectroscopy, where the T(2) value of unsuppressed water signal was determined with a multiecho sequence (T(R)=1.5 s; initial T(E)=35 ms; 64 steps of 2.5 ms; 2 unsuppressed acquisitions per T(E)). Lesion volumes were computed from contrast-enhanced 3D fat-suppressed images. The study found that, using the imaging method of obtaining T(2), the ratio of the product of lesion T(2) and volume after the second cycle of NAC to pretreatment value is a good predictor of ultimate lesion response, defined as a > or =65% reduction in tumor volume after the final treatment cycle, with positive and negative predictive values of 95.5% and 84.6%, respectively.     

Magnetic resonance spectroscopy of the brain in neurologically asymptomatic HIV-infected patients

The CNS involvement is frequently found in human immunodeficiency virus (HIV) infection. The purpose of our study was to determine whether proton magnetic resonance spectroscopy (MRS) could detect early brain involvement in neurologically asymptomatic HIV-infected patients with normal MR imagings and to find the correlation between MRS and the immune status. We performed MRS in 30 HIV seropositive neurologically asymptomatic patients with normal MRI and compared the MRS findings with 13 controls. A statistically significant reduction in N-acetylaspartate (NAA)/creatine (Cr) and N-acetylaspartate (NAA)/choline (Cho) in both centrum semiovale (p < 0.005) and thalamic areas (p < 0.05) was found. There is no statistically significant difference as to choline (Cho)/creatine (Cr) and myoinositol (mI)/creatine (Cr) ratios in both regions. The difference of NAA/Cr was more pronounced in the white matter than in the gray matter. As for the immune status, there was a trend towards correlation between CD4 counts and NAA/Cr but devoid of statistical significance. Our results suggest that MRS is more sensitive than conventional MR imaging in detecting CNS involvement in neurologically asymptomatic HIV patients and may, therefore, be used for early detection of brain damage induced by HIV.     

Proton MR spectroscopy of cerebellitis

Single voxel proton MR spectroscopy ((1)H-MRS) of the vermis was obtained in two patients with cerebellitis. In the acute phase (1)H-MRS revealed low N-acetyl-aspartate (NAA)/creatine (Cr) and NAA/choline (Cho) and normal Cho/Cr ratios. Decrease of the concentration of NAA was confirmed by quantitative analysis in one patient. The NAA/Cr and NAA/Cho ratios and NAA concentration were increased in (1)H-MRS examinations obtained 10 and 24 months after the acute episode. (1)H-MRS demonstrates reversible metabolite changes in cerebellitis.     

Role of apparent diffusion coefficient values for the differentiation of viable and necrotic areas of breast cancer and its potential utility to guide voxel positioning for MRS in the absence of dynamic contrast-enhanced MRI data

We carried out retrospective analysis of apparent diffusion coefficient (ADC) values in 48 infiltrating ductal breast cancer patients who had dynamic contrast-enhanced magnetic resonance imaging (DCEMRI; Group I) and in 53 patients (Group II) for whom DCEMRI data were not available. Twenty-three patients of Group I showed no necrosis (Group Ia), while in 25 patients, both viable (nonnecrotic) and necrotic tumor areas (Group Ib) were observed on DCEMRI. T1-weighted, fat-suppressed and short inversion recovery images were used to identify the viable and necrotic tumor areas in Group II patients, and necrosis was not seen in 11 patients (Group IIa), while 42 (Group IIb) showed both viable and necrotic tumor areas. The ADCs of the necrotic area of Group Ib (1.79±0.30 ×10(-3) mm(2)/s) and Group IIb (1.83±0.40 ×10(-3) mm(2)/s) patients were similar and significantly higher (P<.01) compared to the ADCs of the viable tumor area of Group Ia (0.96±0.21 ×10(-3) mm(2)/s) and Group IIa (0.90±0.17 ×10(-3) mm(2)/s) patients. Proton MR spectroscopy (MRS) data were also available in these patients, and the ADC values were retrospectively determined from the voxel from which MR spectrum was obtained. These values were compared with the ADC obtained for the viable and necrotic areas of the tumor. ADC of the MRS voxel was similar to that obtained for the viable tumor area in patients of both groups. This interesting observation reveals the potential utility of using ADC values to identify viable tumor area for positioning of voxel for MRS in the absence of DCEMRI data.     

The imaging appearance of Creutzfeldt-Jakob disease caused by the E200K mutation

The E200K mutation on chromosome 20 can cause familial Creutzfeldt-Jakob disease (CJD). Patients with this mutation are clinically similar to those with sporadic CJD, but their imaging features are not well documented. We report here the quantitative and qualitative evaluation of the magnetic resonance (MR) imaging characteristics of this unique group of patients using three-dimensional spoiled gradient recalled (SPGR) echo images, diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) measurements, MR spectroscopy and a fluid-attenuated inversion recovery (FLAIR) sequence. The SPGR and ADC data were analyzed with SPM99. ANCOVA and regression models were used for a region-of-interest (ROI) analysis of ADC and metabolic ratios. CJD patients had a decreased fraction of gray matter and an increased fraction of cerebrospinal fluid (P=.001) in the cortex and cerebellum and increased ADC values in the cortex (P<.001). Focal decreases of ADC were found in the putamen via ROI analysis (548+/-83 vs. 709+/-9 microm(2)/s, P=.02). N-acetyl aspartate (NAA) was generally reduced, with the NAA/Cho ratio lowest in the cingulate gyrus. Qualitative assessment revealed hyperintensities on FLAIR, DWI or both in the putamen (three out of four patients), caudate (three out of four patients) and thalamus. These results provide a framework for future study of patients with genetically defined familial CJD.     

Atypical X-linked adrenoleukodystrophy: new MRI observations with FLAIR,magnetization transfer contrast,diffusion MRI,and proton spectroscopy

An 11-year-old boy with an atypical form of X-linked adrenoleukodystrophy is reported predominantly involving the frontal lobes, and later spreading to temporal lobes. Magnetization transfer contrast T1-weighted, and FLAIR images without intravenous paramagnetic contrast medium, clearly identified the leading edge of a central necrotic zone, as well as a splenial lesion. Zonal differences were identified on ADC maps of an echo-planar diffusion MRI sequence that the ADC value of central zone (2.06 x 10(-3) mm(2)/sec) was higher than that of the peripheral zone (1.67 x 10(-3) mm(2)/sec). On proton spectroscopy, besides changes in the peaks of NAA, choline, and myoinositol, prominent peaks between 0.9 and 1.4 ppm were shown belonging to macromolecules, probably to very long chain fatty acids, a diagnostic feature of adrenoleukodystrophy. In addition, a distinct and prominent glycine peak was observed at 3.50 ppm, reflecting excitotoxic brain damage.     

Central pontine myelinolysis after liver transplantation: MR diffusion, spectroscopy and perfusion findings

Magnetic resonance spectroscopy (MRS) and perfusion of central pontine myelinolysis (CPM) have been rarely reported. One case of CPM that developed after liver transplantation was analyzed with serial diffusion-weighted imaging (DWI), MRS and MR perfusion. During the acute phase, a pontine lesion showed an obvious high-signal intensity on DWI with decreased apparent diffusion coefficient value, decreased N-acetylaspartate (NAA)/creatine (Cr) ratio, increased choline (Cho)/Cr ratio and increased perfusion on the cerebral blood volume map. In a later phase, the lesion showed isosignal intensity on DWI, further decreased NAA/Cr ratio, increased Cho/Cr ratio and decreased perfusion. The increase in lesion perfusion during the acute phase may reflect a higher metabolic activity due to an increase in cell number and activity.     

1H-MRS of the macaque monkey primary visual cortex at 7 T: strategies and pitfalls of shimming at the brain surface

Magnetic resonance spectroscopy (MRS) is ideally suited for physiology-neurochemistry experiments with the living brain and particularly for studies on the primary visual cortex (striate cortex or area V1). Yet, the highly convoluted form of the human V1 has thus far prevented the performance of MRS investigations that are spatially confined within the gray matter of this area. Typically, these studies are compromised by partial volume contaminations originating from white matter tissue, cerebrospinal fluid and other cortical areas. In this study, was exploited the relative flatness of V1 in macaques to enable single-voxel 1H-MRS from a small volume (5 x 1.6 x 5 mm3, 40 microl) that was entirely confined within the V1 gray matter of anesthetized monkeys. Linewidths of 13.5+/-1.9 Hz and 13.0+/-1.3 Hz for water and creatine, respectively, were achieved with a two-step shimming strategy for voxels at the brain surface. The quality of the obtained results paves the way for further neuroscientific research, including studies on the cortical microcircuits and the dynamic longitudinal changes occurring during cortical reorganization and plasticity.     

低场MRI系统中线扫描扩散张量成像方法的研究

磁共振扩散张量成像(DTI)是在扩散加权成像(DWI)基础上发展起来的一种新型技术,可以无创伤显示脑白质纤维,诊断脑白质病变. 但是由于各种原因,DTI一般只在超导高场磁共振成像(MRI)仪器上进行,这就限制了这一重要诊断手段临床应用的广泛性. 本文在低场磁共振成像系统上应用线扫描实现了扩散张量成像,并测量了健康志愿者大脑内主要解剖结构的表观扩散系数(ADC)和各项异性分数(FA),得到的数据与高场仪器上的相关数据比较是吻合的. 因此临床上使用在低场强上得到的DTI图像评价脑白质是可行的,而且通常在临床上这也是足够的.     

Differentiation of recurrent brain tumor versus radiation injury using diffusion tensor imaging in patients with new contrast-enhancing lesions

BACKGROUND AND PURPOSE: The purpose of this study was to assess the use of diffusion tensor imaging (DTI) in the evaluation of new contrast-enhancing lesions and perilesional edema in patients previously treated for brain neoplasm in the differentiation of recurrent neoplasm from treatment-related injury. METHODS: Twenty-eight patients with new contrast-enhancing lesions and perilesional edema at the site of previously treated brain neoplasms were retrospectively reviewed. Nine directional echoplanar DTIs with b=1000 s/mm(2) were obtained using a single-shot spin-echo echoplanar imaging. Standardized regions of interest were manually drawn in several regions. Mean apparent diffusion coefficient (ADC), fractional anisotropy (FA) and eigenvalue indices (lambda( parallel) and lambda( perpendicular)) and their ratios relative to the contralateral side were compared in patients with recurrent neoplasm versus patients with radiation injury, as established by histological examination or by clinical course, including long-term imaging studies and magnetic resonance spectroscopy. RESULTS: The ADC values in the contrast-enhancing lesions were significantly higher (P=.01) for the recurrence group (range=1.01 x 10(-3) to 1.66 x 10(-3) mm(2)/s; mean+/-S.D.=1.27+/-0.15) than for the nonrecurrence group (range=0.9 x 10(-3) to 1.31 x 10(-3) mm(2)/s; mean+/-S.D.=1.12+/-0.14). The ADC ratios in the white matter tracts in perilesional edema trended higher (P=.09) in treatment-related injury than in recurrent neoplasm (mean+/-S.D.=1.85+/-0.30 vs. 1.60+/-0.27, respectively). FA ratios were significantly higher in normal-appearing white matter (NAWM) tracts adjacent to the edema in the nonrecurrence group (mean+/-S.D.=0.89+/-0.15) than in those in the recurrence group (mean+/-S.D.=0.74+/-0.14; P=.03). Both eigenvalue indices lambda( parallel) and lambda( perpendicular) were significantly higher in contrast-enhancing lesions in the recurrence group than in those in the nonrecurrence group (P=.02). As well, both eigenvalue indices lambda( parallel) and lambda( perpendicular) were significantly higher in perilesional edema than in normal white matter (P<.01 and P<.001, respectively) in both groups. CONCLUSION: The assessment of diffusion properties, especially ADC values and ADC ratios, in contrast-enhancing lesions, perilesional edema and NAWM adjacent to the edema in the follow-up of new contrast-enhancing lesions at the site of previously treated brain neoplasms may add to the information obtained by other imaging techniques in the differentiation of radiation injury from tumor recurrence.     

Integration of quantitative DCE-MRI and ADC mapping to monitor treatment response in human breast cancer: initial results

PURPOSE: The objective of this study was to assess changes in the water apparent diffusion coefficient (ADC) and in pharmacokinetic parameters obtained from the fast-exchange regime (FXR) modeling of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) during neoadjuvant chemotherapy in breast cancer. MATERIALS AND METHODS: Eleven patients with locally advanced breast cancer underwent MRI examination prior to and after chemotherapy but prior to surgery. A 1.5-T scanner was used to obtain T1, ADC and DCE-MRI data. DCE-MRI data were analyzed by the FXR model returning estimates of K(trans) (volume transfer constant), v(e) (extravascular extracellular volume fraction) and tau(i) (average intracellular water lifetime). Histogram and correlation analyses assessed parameter changes post-treatment. RESULTS: Significant (P < .05) changes or trends towards significance (P < .10) were seen in all parameters except tau(i), although there was qualitative reduction in tau(i) values post-treatment. In particular, there was reduction (P < .035) in voxels with K(trans) values in the range 0.2-0.5 min(-1) and a decrease (P < .05) in voxels with ADC values in the range 0.99 x 10(-3) to 1.35 x 10(-3) mm2/s. ADC and v(e) were negatively correlated (r = -.60, P < .02). Parameters sensitive to water distribution and geometry (T(1), v(e), tau(i) and ADC) correlated with a multivariable linear regression model. CONCLUSION: The analysis presented here is sensitive to longitudinal changes in breast tumor status; K(trans) and ADC are most sensitive to these changes. Relationships between parameters provide information on water distribution and geometry in the tumor environment.     

Brain metabolite alterations demonstrated by proton magnetic resonance spectroscopy in diabetic patients with retinopathy

Due to the homology between retinal and cerebral microvasculatures, retinopathy is a putative indicator of cerebrovascular dysfunction. This study aimed to detect metabolite changes of brain tissue in type 2 diabetes mellitus (T2DM) patients with diabetic retinopathy (DR) using proton magnetic resonance spectroscopy (¹H-MRS). Twenty-nine T2DM patients with DR (DR group), thirty T2DM patients without DR (DM group) and thirty normal controls (NC group) were involved in this study. Single-voxel ¹H-MRS (TR: 2000 ms, TE: 30 ms) was performed at 3.0 T MRI/MRS imager in cerebral left frontal white matter, left lenticular nucleus, and left optic radiation. Our data showed that NAA/Cr ratios of the DR group were significantly lower than those of the DM group in the frontal white matter and optic radiation. In the lenticular nucleus, MI/Cr ratios were significantly higher in the DM group than those in the NC group, while MI/Cr ratios were significantly lower in the DR group than those in the DM group. In the frontal white matter, NAA/Cho ratios were found to be decreased in the DR group as compared to the NC group. Additionally, our finding indicated that NAA/Cr ratios were negatively associated with DR severity in both the frontal white matter and optic radiation. A decrease in NAA indicated neuronal loss and the likely explanation for a decrease in MI was glial loss. In conclusion, we inferred that cerebral neurons and glia cells were damaged in patients with DR. Our data support that DR is associated with brain tissue damage.     

An assessment of the sharpness of carotid artery tissue boundaries with acquisition voxel size and field strength

A measure of the sharpness of vessel wall interfaces in carotid artery MRI may be useful for assessing the conspicuity of the wall's features. An edge detection technique was used to measure the signal intensity gradients in 2D time-of-flight (2D-TOF) and double-inversion recovery black-blood (DIR-BB) carotid artery images of normal subjects that were acquired at 1.5 T with 0.55 x 0.55 x 2.0-mm (0.6 mm3) acquisition voxels and zero filled to reduce the in-plane reconstructed voxel size by one half in each dimension as well as with 0.27 x 0.27 x 2.0-mm (0.15 mm3) acquisition voxels and at 3.0 T with 0.27 x 0.27 x 2.0-mm (0.15 mm3) acquisition voxels using surface coils. The gradient intensities of the lumen-to-background interface varied closely with the contrast-to-noise ratio of the 2D-TOF imaging. For the DIR-BB imaging, in which higher spatial frequency artery structures are visible, the gradient intensities at the interfaces were higher than theoretically predicted at both field strengths with smaller acquisition voxels. The use of acquisition voxels smaller than those previously used at 1.5 T can improve the visualization of carotid artery structures at 1.5 and 3.0 T with surface coil reception.     

Single-shot fast spin-echo diffusion tensor imaging of the lumbar spine at 1.5 and 3 T

Diffusion tensor imaging (DTI) of the lumbar spine could improve diagnostic specificity. The purpose of this work was to determine the feasibility of and to validate DTI with single-shot fast spin-echo (SSFSE) for lumbar intervertebral discs at 1.5 and 3 T. Six normal volunteers were scanned with DTI-SSFSE using an eight- and a three-b-value protocol at 1.5 and 3 T, respectively. Apparent diffusion coefficient (ADC) values were computed and validated based on those obtained at 1.5 T from corresponding diffusion tensor scans using line scan diffusion imaging (LSDI), a technique that has been previously validated for use in the spine. Pearson correlation coefficients for LSDI and DTI-SSFSE ADC values were .88 and .89 for 1.5 and 3 T, respectively, with good quantitative agreement according to the Bland-Altman method. Results indicate that DTI-SSFSE is a candidate as a clinical sequence for obtaining diffusion tensor images of the lumbar intervertebral discs with scan times shorter than 4 min.     

Optimal paths in disordered media: scaling of the crossover from self-similar to self-affine behavior

We study optimal paths in disordered energy landscapes using energy distributions of the type P(log(10) E)=const that lead to the strong disorder limit. If we truncate the distribution, so that P(log(10) E)=const only for E(min) < or =E < or =E(max), and P(log(10) E)=0 otherwise, we obtain a crossover from self-similar (strong disorder) to self-affine (moderate disorder) behavior at a path length l(x). We find that l(x) proportional, variant[log(10)(E(max)/E(min))](kappa), where the exponent kappa has the value kappa=1.60 +/- 0.03 both in d=2 and d=3. We show how the crossover can be understood from the distribution of local energies on the optimal paths.     

Experimental hypoxic–ischemic encephalopathy: comparison of apparent diffusion coefficients and proton magnetic resonance spectroscopy

This study aims to compare the apparent diffusion coefficients (ADCs) and proton magnetic resonance spectroscopy (¹H-MRS) in the first 24 h of acute hypoxic-ischemic brain damage (HIBD) in piglets. Twenty-five 7-day-old piglets were subjected to transient bilateral common carotid artery occlusion followed by ventilation with 4% oxygen for 1 h. Diffusion-weighted imaging (DWI) and ¹H-MRS were performed on cessation of the insult or at 3, 6, 12 or 24 h after resuscitation (all n=5). ADCs, N-acetylaspartate/choline (NAA/Cho), NAA/creatine (NAA/Cr), lactate/NAA (Lac/NAA), Lac/Cho and Lac/Cr were calculated. Cerebral injury was evaluated by pathological study and Hsp70 immunohistochemical analysis. On cessation of the insult, ADCs, NAA/Cho and NAA/Cr reduced, Lac/NAA, Lac/Cho and Lac/Cr increased. From 3 to 12 h after resuscitation, ADCs, Lac/NAA, Lac/Cho and Lac/Cr recovered, NAA/Cho and NAA/Cr reduced. Twenty-four hours after resuscitation, ADCs reduced once more, Lac/NAA, Lac/Cho and Lac/Cr increased again, whereas NAA/Cho and NAA/Cr decreased continuously. Pathological study revealed mild cerebral edema on cessation of the insult and more and more severe cerebral injury after resuscitation. No Hsp70-positive cells were detected on cessation of the insult. From 3 to 12 hours after resuscitation, Hsp70-positive cells gradually increased. Twenty-four hours after resuscitation, Hsp70-positive cells decreased. Throughout the experiment, changes in NAA/Cho and pathology had the best correlation (R=–0.729). In conclusion, NAA/Cho is the most precise ratio to reflect the pathological changes of early HIBD. Transient ADCs and Lac ratios recovery do not predict the reversal of histological damage of early HIBD. Reducing astrocytic swelling is of great clinical significance.     

Magnetic resonance studies of laryngeal tumors implanted in nude mice: effect of treatment with bleomycin and electroporation

Recently, a new type of cancer treatment has been introduced that combines pulsed electric fields (PEF) with anticancer drugs. The proposed mode of action is that PEF create transient pores in the membranes which allow entry of drugs into the cells. This method increases cytotoxicity of some anticancer drugs like bleomycin (BLM) by 2-3 orders of magnitude, which, in turn, reduces systemic drug dosage without decreasing efficacy. In the present study, magnetic resonance imaging (MRI) was used to determine changes in apparent water self-diffusion coefficients (ADC) and spin-lattice (T(1)) and spin-spin (T(2)) relaxation times that occur in an animal laryngeal tumor (HEp-2 cells) model with BLM delivered by PEF. A Bruker 14 Tesla (600 MHz) wide-bore spectrometer with micro-imaging capability was used to generate all the data. Mice carrying approximately 8 mm tumors were treated with several combinations of drug and PEF. All measurements were made on tumor samples excised from mice 24 and 48 hours after treatment with (i) saline, intratumor injection (i.t.), (ii) BLM, i.t., (iii) saline with PEF, and (iv) BLM, i.t., followed by PEF. Although T(1) does not differ between the controls (i, ii, and iii) and full treatment (iv) 6.72 +/- 0.20 s vs. 6.31 +/- 1.7 s, T(2) for (iv) at 24 hours is significantly different from the controls 52.4 +/- 0.91 ms vs. 46.5 +/- 1.54 ms. T(2) differences between treatment and controls disappear at 48 hours. ADC increases significantly from 24 to 48 hours (7.31 +/- 0.16 x 10(-6) to 8.28 +/- 0.28 x 10(-6) cm(2)/sec, p = 0.05). Longer T(2) values may reflect early apoptosis and tumor death when the tumor is structurally less dense. Higher ADC's, associated with the periphery of the tumors and the central region, may indicate loose structural organization and necrosis resulting from the combination treatment.     

Evaluation of Disease Stage of Radiation-Induced Brain Injury: a DTI Study with Pathological Correlation

The aim of this study is to evaluate if diffusion tensor imaging (DTI) can distinguish the disease process of radiation-induced brain injury when combined with apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values. Twenty-one rabbits received irradiation of 100 Gy in the right brain hemisphere. Twelve rabbits were screened with magnetic resonance imaging (MRI) and DTI before radiation, and imaged at every week until week 9 following radiation. The rabbits that had MRI were euthanized at week 9 for histologic evaluation, while other nine rabbits without MRI were randomly killed for histologic evaluation at weeks 2, 4 and 6, respectively. From the DTI, the ADC and FA values were measured, and rADC and rFA were calculated. After radiation, the trend of the ADC value can be divided into three stages. In the first stage, the ADC value of the target tissues gradually decreased. In the second stage, the ADC value of white matter in the target tissues showed a recovery trend, back to the initial level similar to that in contralateral. In the third stage, the ADC value of white matter in the target tissue continues to increase over the ADC value of baseline and contralateral white matter. The FA value of radiation-targeted area showed continuous decreasing tendency. Pathological evaluation showed the different features in three stages. DTI can distinguish the different disease stages when combined with the ADC and FA values.