, Volume 46, Issue 10, pp 805–811 | Cite as

Glucocorticoid treatment of brain tumor patients: changes of apparent diffusion coefficient values measured by MR diffusion imaging

  • Sosuke MinamikawaEmail author
  • Kinuko Kono
  • Keiko Nakayama
  • Hiroyuki Yokote
  • Takahiko Tashiro
  • Akimasa Nishio
  • Mitsuhiro Hara
  • Yuichi Inoue
Dignostic Neuroradiology


Glucocorticoids (GCC) generally are administered to patients with brain tumors to relieve neurological symptoms by decreasing the water content in a peritumoral zone of edema. We hypothesized that diffusion imaging and apparent diffusion coefficient (ADC) values could detect subtle changes of water content in brain tumors and in peritumoral edema after GCC therapy. The study consisted of 13 patients with intra-axial brain tumor, and ADC was measured in the tumor, within peritumoral edema, and in normal white matter remote from the tumor before and after GCC therapy. ADC also was measured in normal white matter in four control patients with no intracranial disease who were treated with GCC for other indications. Conventional MR images showed no visually evident interval change in tumor size or the extent of peritumoral edema in any subject after GCC therapy, which nonetheless resulted in a decrease in mean ADC of 7.0% in tumors (P<0.05), 1.8% in peritumoral edema (P>0.05, not significant) and 5.8% in normal white matter (P<0.05). In patients with no intracranial disease, GCC therapy decreased mean ADC in white matter by 5.4% (P<0.05). ADC measurement can demonstrate subtle changes in the brain after GCC therapy that cannot be observed by conventional MR imaging. Measurement of ADC proved to be a sensitive means of assessing the effect of GCC therapy, even in the absence of visually discernible changes in conventional MR images.


Glucocorticoid Brain tumor Brain edema Diffusion-weighted images ADC 


  1. 1.
    Neil JJ, Shiran SI, McKinstry RC et al. (1998) Normal brain in human newborns: apparent diffusion coefficient and diffusion anisotropy measured by using diffusion tensor MR imaging. Radiology 209:57–66Google Scholar
  2. 2.
    Hatam A, Yu ZY, Bergstrom M, Berggren BM, Greitz T (1982) Effects of dexamethasone treatment on peritumoral brain edema evaluation by computed tomography. J Comput Assist Tomogr 6:586–592PubMedGoogle Scholar
  3. 3.
    Bothe HW, Bodsch W, Hossmann KA (1984) Relationship between specific gravity, water content, and serum protein extravasation in various type of vasogenic brain edema. Acta Neuropathol (Berl) 64:37–42Google Scholar
  4. 4.
    Jarden JO, Dhawan V, Poltorak A, Posner JB, Rottenberg DA (1985) Positron emission tomographic measurement of blood-to-brain and blood-to-tumor transport of 82Rb: The effect of dexamethasone and whole-brain radiation therapy. Ann Neurol 18:636–646PubMedGoogle Scholar
  5. 5.
    Leenders KL, Beaney RP, Brooks DJ, et al (1985) Dexamethasone treatment of brain tumor patients: effect on regional cerebral blood flow, blood volume, and oxygen utilization. Neurology 35:1610–1616PubMedGoogle Scholar
  6. 6.
    Bodsch W, Rommel T, Ophoff BG, Menzel J (1987) Factors responsible for the retention of fluid in human tumor edema and the effect of dexamethasone. J Neurosurg 67:250–257Google Scholar
  7. 7.
    Ohnishi T, Hayakawa T, Shapiro WR (1990) Human malignant gliomas secrete a factor that increases brain capillary permeability: role in peritumoral brain edema. Acta Neurochir (Wien) [Suppl 51]:137–139Google Scholar
  8. 8.
    Ostergaard L, Hochberg FH, Rabinov JD, et al (1999) Early changes measured by magnetic resonance imaging in cerebral blood flow, blood volume, and blood-brain barrier permeability following dexamethasone treatment in patients with brain tumors. J Neurosurg 90:300–305.Google Scholar
  9. 9.
    Hossman KA (1989) The pathophysiology of experiment brain edema. Neurosurg Rev 12:263–280PubMedGoogle Scholar
  10. 10.
    Reulen HJ, Graham R, Spatz M, Klatzo I (1977) Role of pressure gradients and bulk flow of dynamics of vasogenic edema. J Neurosurg 46:24–35Google Scholar
  11. 11.
    Reulen HJ, Tsuyumu M, Tack A, Fenske AR, Prioleau GR (1978) Clearance of edema fluid into cerebrospinal fluid. A mechanism for resolution of vasogenic brain edema. J Neurosurg 48:754–764Google Scholar
  12. 12.
    Bell BA, Kean DM, MacDonald HL, et al (1987) Brain water measured by magnetic resonance imaging. Correlation with direct estimation and changes after mannitol and dexamethasone. Lancet 66–69Google Scholar
  13. 13.
    Andersen C, Haselgrove JC, Doenstrup S, Astrup J, Gyldensted C (1993) Resrption of peritumoral oedema in cerebral gliomas during glucocorticoid treatment evaluated by NMR relaxation time imaging. Acta Neurochir (Wien) 122:218–224Google Scholar
  14. 14.
    Andersen C, Astrup J, Gyldensted C (1994) Quantitative MR analysis of glucocorticoid effects on peritumoral edema associated with intracranial meningiomas and metastases. J Comput Assist Tomogr 18:509–518PubMedGoogle Scholar
  15. 15.
    Bastin ME, Delgado M, Whittle IR, Cannon J, Wardlaw JM (1999) The use of diffusion tensor imaging in quantifying the effect of dexamethasone on brain tumours. Neuro Report 10:1385–1391Google Scholar
  16. 16.
    Hossmann KA, Hurter T, Oschlies U (1983) The effect of dexamethasone on serum protein extravasation and edema development in experimental brain tumors of cat. Acta Neuropathol (Berl) 60:223–231Google Scholar
  17. 17.
    Bentson J, Reza M, Winter J, Wilson G (1978) Steroids and apparent cerebral atrophy on computed tomography scans. J Comput Assist Tomogr 2:16–23PubMedGoogle Scholar
  18. 18.
    Zanardi VA, Magna LA, Costallat LTL. (2001) Cerebral atrophy related to corticotherapy in systemic lupus erythematosus (SLE). Clin Rheumatol 20:245–250CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Sosuke Minamikawa
    • 1
    Email author
  • Kinuko Kono
    • 1
  • Keiko Nakayama
    • 1
  • Hiroyuki Yokote
    • 1
  • Takahiko Tashiro
    • 1
  • Akimasa Nishio
    • 2
  • Mitsuhiro Hara
    • 2
  • Yuichi Inoue
    • 1
  1. 1.Department of RadiologyOsaka City University Graduate School of MedicineOsakaJapan
  2. 2.Department of NeurosurgeryOsaka City University Graduate School of MedicineOsakaJapan

Personalised recommendations