Neurosurgery Unit, Department of Neurosciences, Catholic University School of Medicine, Rome, Italy.
Department of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli Largo Agostino Gemelli 1, Rome, 00168, Italy.
Neurosurg Rev. 2024 Jul 2;47(1):301. doi: 10.1007/s10143-024-02529-3.
Given that glioma cells tend to infiltrate and migrate along WM tracts, leading to demyelination and axonal injuries, Diffusion Tensor Imaging (DTI) emerged as a promising tool for identifying major "high-risk areas" of recurrence within the peritumoral brain zone (PBZ) or at a distance throughout the adjacents white matter tracts. Of our systematic review is to answer the following research question: In patients with brain tumor, is DTI able to recognizes within the peri-tumoral brain zone (PBZ) areas more prone to local (near the surgical cavity) or remote recurrence compared to the conventional imaging techniques?. We conducted a comprehensive literature search to identify relevant studies in line with the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. 15 papers were deemed compatible with our research question and included. To enhance the paper's readability, we have categorized our findings into two distinct groups: the first delves into the role of DTI in detecting PBZ sub-regions of infiltration and local recurrences (n = 8), while the second group explores the feasibility of DTI in detecting white matter tract infiltration and remote recurrences (n = 7). DTI values and, within a broader framework, radiomics investigations can provide precise, voxel-by-voxel insights into the state of PBZ and recurrences. Better defining the regions at risk for potential recurrence within the PBZ and along WM bundles will allow targeted therapy.
鉴于神经胶质瘤细胞往往沿着 WM 束浸润和迁移,导致脱髓鞘和轴突损伤,扩散张量成像 (DTI) 已成为识别肿瘤周围脑区 (PBZ) 或在相邻白质束远处复发的主要“高风险区域”的有前途的工具。我们的系统评价旨在回答以下研究问题:在脑肿瘤患者中,DTI 是否能够识别 PBZ 内与常规成像技术相比更容易发生局部(靠近手术腔)或远处复发的区域?我们进行了全面的文献检索,以根据 PRISMA-P(系统评价和荟萃分析议定书的首选报告项目)指南确定符合我们研究问题的相关研究。有 15 篇论文被认为与我们的研究问题相符并被纳入。为了提高论文的可读性,我们将研究结果分为两组:第一组探讨了 DTI 在检测 PBZ 浸润和局部复发的亚区(n=8)中的作用,第二组探讨了 DTI 在检测白质束浸润和远处复发的可行性(n=7)。DTI 值,以及更广泛的放射组学研究,可以提供关于 PBZ 和复发状态的精确、体素级别的见解。更好地定义 PBZ 内和 WM 束沿线的潜在复发风险区域将允许靶向治疗。
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