Purpose: Corpus callosum (CC) is a main channel histologically for glioma spreading, downgrading the prognosis, the infiltration occurring through cellular reaction-diffusion process. Preliminary clinical trial indicates that CC's surgical interruption appreciably enhances clinical outcome. We aim to find how high-grade glioma phenomenology is reflected in CC parameters, including various 3D diffusion eigenvalues differentially, whereby this information may be utilized for planning radiotherapy and surgical intervention.
Methods: Using 3 Tesla MRI diffusion-tensor imaging of glioma patients and matched controls, we formulated the callosal volume, fibre count, and 3D directional diffusivity eigenvalues (λ-λ-λ), utilizing FDT/FMRIB-based analysis.
Results: In glioma, the callosal volume, fibre count and normalized volume decreases (p < 0.001), while axial diffusivity λ and radial diffusivity component λ significantly increase (p = 0.03, p = 0.04). Though not expected, the other radial diffusivity component λ remains unchanged (p = 0.11). Increase of λ and λ is due to gliomatous migration across the two directions (eigenvectors of λ, λ), which correlate respectively with medio-lateral commissural fibres and dorso-ventral perforating fibres in CC. These are corroborated by collateral radiological findings and immunohistological staining of those two fibre-systems in cat and human.
Conclusion: In glioma, the two diffusivities (λ, λ), enhance due to fluidic edema permeation through CC's bi-axial lamina-type structural scaffold, formed by mediolateral commissural fibres and dorsoventral perforating cingulo-septal fibres. On other hand, the two radial diffusivities (λ, λ) are physiologically different and can be distinguished as lamellar diffusivity and focal diffusivity respectively. Lamellar diffusivity λ needs to be considered for MRI-assisted surgical intervention and radiotherapy planning in glioma.
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