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Increased diffusion in the normal appearing white matter of brain tumor patients: is this just tumor infiltration?

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Abstract

Altered diffusion in the normal appearing white matter (NAWM) of glioma patients has been explained by tumor infiltration. The goal of the present study was to test this explanation indirectly by examining whether these alterations were also present in the contralateral NAWM of non-infiltrative tumors like meningiomas; and to search for other possible reasons for this abnormality. Twenty-seven patients with histologically verified glioma (grade II–IV), 22 meningioma patients and two groups of age- and sex-matched healthy controls underwent diffusion weighted imaging (DWI) on a 3T MR. All patients were examined before treatment. Apparent diffusion coefficient (ADC) values were calculated in the entire NAWM of the hemisphere contralateral to the tumor. ADC values of the NAWM were compared between groups with Mann–Whitney U-test and multiple linear regression. The relations of ADC in NAWM to glioma grade and to tumor volume were also investigated. ADC values of the contralateral NAWM were significantly higher in both glioma and meningioma patients compared to controls (P = 0.0006 and 0.0099, respectively). ADC value was higher in the NAWM of high grade gliomas than in low grade gliomas (P = 0.0181) and in healthy control subjects (P = 0.0003). ADC did not depend on tumor volume in any of the patient groups. Elevated ADC in the NAWM of both glioma and meningioma patients might indicate that the effect of infiltrating tumor cells is not the only reason for the alteration as it has been previously suggested. Although the role of mass effect was not proved, other mechanisms might also contribute to ADC elevation.

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Acknowledgments

This study was supported by the following grants: Developing Competitiveness of Universities in the South Transdanubian Region (SROP-4.2.1.B-10/2/KONV-2010-0002 and SROP-4.2.2.A-11/1/KONV-2012-0017), “PTE ÁOK-KA-2013/12”, Hungarian Brain Research Program—“KTIA_13_NAP-A-II/9”, Hungarian Brain Research Program “B” (KTIA_NAP_13-2-2014-0019) and The Hungarian Research Found (OTKA PD103964).

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Authors and Affiliations

  1. Diagnostic Center of Pécs, 2. Rét st., Pécs, 7623, Hungary

    Andrea Horváth, Gábor Perlaki, Arnold Tóth, Gergely Orsi, Szilvia Nagy & Péter Bogner

  2. Department of Neurosurgery, University of Pécs, Pécs, Hungary

    Andrea Horváth, Arnold Tóth, Tamás Dóczi & Zsolt Horváth

  3. Department of Radiology, University of Pécs, Pécs, Hungary

    Arnold Tóth & Péter Bogner

  4. MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary

    Gábor Perlaki, Gergely Orsi & Tamás Dóczi

  5. MTA-PTE, Neurobiology of Stress Research Group, Pécs, Hungary

    Szilvia Nagy

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  1. Andrea Horváth
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Correspondence to Péter Bogner.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The present scientific contribution is dedicated to the 650th anniversary of the foundation of the University of Pécs, Hungary.

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Horváth, A., Perlaki, G., Tóth, A. et al. Increased diffusion in the normal appearing white matter of brain tumor patients: is this just tumor infiltration?. J Neurooncol 127, 83–90 (2016). https://doi.org/10.1007/s11060-015-2011-y

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  • DOI: https://doi.org/10.1007/s11060-015-2011-y

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