Departments of Radiation Oncology, Radiology, and Biomedical Engineering, University of Michigan, Ann Arbor, MI.
Tomography. 2020 Mar;6(1):34-43. doi: 10.18383/j.tom.2020.00018.
Apparent diffusion coefficient has limits to differentiate solid tumor from normal tissue or edema in glioblastoma (GBM). This study investigated a microstructure model (MSM) in GBM using a clinically available diffusion imaging technique. The MSM was modified to integrate with bi-polar diffusion gradient waveforms, and applied to 30 patients with newly diagnosed GBM. Diffusion-weighted (DW) images acquired on a 3 T scanner with b-values from 0 to 2500 s/mm were fitted in volumes of interest (VOIs) of solid tumor to obtain the apparent restriction size of intracellular water (), the fractional volume of intracellular water ( ), and extracellular ( ) water diffusivity. The parameters in solid tumor were compared with those of other tissue types by Students' test. For comparison, DW images were fitted by conventional mono-exponential and bi-exponential models. , , and from the MSM in tumor VOIs were significantly greater than those in WM, GM, and edema ( values of .01-.001). values in solid tumors (from 21.6 to 34.5 um) had absolutely no overlap with those in all other tissue types (from 0.9 to 3.5 um). values showed a descending order from solid tumor (from 0.32 to 0.52) to WM, GM, and edema (from 0.05 to 0.25), consisting with the descending cellularity in these tissue types. The parameters from mono-exponential and bi-exponential models could not significantly differentiate solid tumor from all other tissue types, particularly from edema. Further development and histopathological validation of the MSM will warrant its role in clinical management of GBM.
表观扩散系数在区分胶质母细胞瘤(GBM)中的实体瘤与正常组织或水肿方面存在局限性。本研究使用临床可用的扩散成像技术对 GBM 中的微结构模型(MSM)进行了研究。对 MSM 进行了修改,以整合双极扩散梯度波形,并应用于 30 例新诊断的 GBM 患者。在 3T 扫描仪上采集扩散加权(DW)图像,b 值范围为 0 至 2500 s/mm2,在实体瘤的感兴趣体积(VOI)中对 DW 图像进行拟合,以获得细胞内水的表观限制大小()、细胞内水的分数体积()和细胞外()水扩散系数。通过学生 t 检验比较固体肿瘤中的参数与其他组织类型的参数。为了比较,通过传统的单指数和双指数模型对 DW 图像进行拟合。来自 MSM 的肿瘤 VOI 的、和值明显大于 WM、GM 和水肿(值为 0.01-0.001)。固体肿瘤中的值(范围为 21.6 至 34.5 µm)与所有其他组织类型(范围为 0.9 至 3.5 µm)的完全没有重叠。值显示出从实体瘤(范围为 0.32 至 0.52)到 WM、GM 和水肿(范围为 0.05 至 0.25)的降序排列,与这些组织类型中细胞密度的降低一致。单指数和双指数模型的参数不能显著区分实体瘤与所有其他组织类型,特别是与水肿。MSM 的进一步开发和组织病理学验证将证明其在 GBM 临床管理中的作用。