Pre and Post-operative evaluation of brain neoplasms on Diffusion Tensor Imaging

Abstract

Context: Complex neural networks are formed by the communication of billions of neurons with each other through their axons. Limitation to the understanding of brain function, due to the lack of non-invasive methods makes it essential to recognize such networks by structural mapping.

Aims: We conducted this study with the aim of evaluating various brain neoplasms pre and post operatively and help guide the neurosurgeon for better resection of the tumor.Settings and Design: The study was conducted in Department of Radio-diagnosis, Dr. D. Y. Patil medical college, hospital and research center by using 3T MR scanner (Siemens Magnetom Vida) on 30 histopathologically proven cases of intracerebral neoplasms. The study design was Cross sectional observational study. Statistical analysis used: The data was entered in MS EXCEL spreadsheet and analysis done using licensed Statistical Package for Social Sciences (SPSS) version 21.0.  Descriptive statistics (means and SDs) for each parameter were computed for the different tumor groups. The tumor groups were compared by using student or non-parametric sample tests. A ‘p’ value of <0.05 was considered statistically significant.Results: Or study showed that DTI can be helpful in differentiating low from high grade neoplasms. Various white matter tracts adjacent to the neoplasm were visualized and classified into displaced, edematous, infiltrated and destroyed depending upon the type of involvement by the neoplasm. Post operative KPS score showed improvement as compared to the pre-operative KPS score, highlighting value of DTI. Conclusions: Tract visualization can be extremely helpful for neurosurgeons in differentiating salvageable from lost tracts, thus DTI is an important tool in the arsenal of a neurosurgeon.

Keywords: DTI, MRI, intracerebral, neoplasm, edema