Individual Brain Tumor Invasion Mapping Based on Diffusion Kurtosis Imaging.

Unlabelled: is to develop and implement an algorithm for image analysis in brain tumors (glioblastoma and metastasis) based on diffusion kurtosis MRI images (DKI) for the assessment of anisotropic changes in brain tissues in the directions from the tumor to the intact (as shown by the standard MRI data) white matter, which will enable generating individual tumor invasion maps.

Materials And Methods: A healthy volunteer and two patients (one with glioblastoma and the other with a single metastasis of small cell lung cancer) were examined by DKI obtaining 12 parametric kurtosis maps for each participant.

Results: During the investigation, we have developed an algorithm of DKI analysis and plotting the profile of tissue parameters in the direction from the tumor towards the unaffected white matter according to the data of standard MRI. Changes of the DKI indicators along the trajectories built using the proposed algorithm in the perifocal zone of glioblastoma and metastasis have been compared in this work. We obtained not only changes in the parameters (gradients in trajectory plots) but also a visual reflection (on color maps) of a known pathomorphology of the process - no significant gradients of DKI parameters were detected in the perifocal metastasis edema, since there was a pure vasogenic edema and no infiltrative component. In glioblastoma, gradients of DKI parameters were found not only in the zone of perifocal edema but beyond the zone of MR signal as well, which is believed to reflect diffusion disorders along the white matter fibers and different degrees of brain tissue infiltration by glioblastoma cells.

Conclusion: The developed algorithm of DKI analysis in brain tumors makes it possible to determine the degree of changes in the tissue microstructure in the perifocal zone of brain glioblastoma relative to the metastasis. The study aimed at obtaining individual maps of tumor invasion, which will be applied in planning neurosurgical and radiation treatment and for predicting directions of further growth of malignant gliomas.