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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleAdult Brain
Open Access

DWI for Monitoring the Acute Response of Malignant Gliomas to Photodynamic Therapy

Y. Fujita, T. Sasayama, K. Tanaka, K. Kyotani, H. Nagashima, M. Kohta, H. Kimura, A. Fujita and E. Kohmura
American Journal of Neuroradiology December 2019, 40 (12) 2045-2051; DOI: https://doi.org/10.3174/ajnr.A6300
Y. Fujita
aFrom the Department of Neurosurgery (Y.F., T.S., K.T., M.K., H.K., A.F., E.K.), Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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T. Sasayama
aFrom the Department of Neurosurgery (Y.F., T.S., K.T., M.K., H.K., A.F., E.K.), Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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K. Tanaka
aFrom the Department of Neurosurgery (Y.F., T.S., K.T., M.K., H.K., A.F., E.K.), Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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K. Kyotani
bCenter for Radiology and Radiation Oncology (K.K.), Kobe University Graduate School of Medicine and Kobe University Hospital, Kobe, Hyogo, Japan
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H. Nagashima
cDepartment of Neurosurgery (H.N.), Massachusetts General Hospital Research Institute, Boston, Massachusetts.
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M. Kohta
aFrom the Department of Neurosurgery (Y.F., T.S., K.T., M.K., H.K., A.F., E.K.), Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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H. Kimura
aFrom the Department of Neurosurgery (Y.F., T.S., K.T., M.K., H.K., A.F., E.K.), Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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A. Fujita
aFrom the Department of Neurosurgery (Y.F., T.S., K.T., M.K., H.K., A.F., E.K.), Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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E. Kohmura
aFrom the Department of Neurosurgery (Y.F., T.S., K.T., M.K., H.K., A.F., E.K.), Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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Article Figures & Data

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    Fig 1.

    Flow chart showing the patient selection process. LGG indicates low-grade glioma; BCNU, biodegradable carmustine.

  • Fig 2.
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    Fig 2.

    A representative case in the PDT group. Preoperative DWI (A), ADC map (G), CE-T1WI (M), and FLAIR (S) demonstrate the lesion with a cyst in the right frontal lobe. Postoperative DWI (B–F), ADC map (H–L), CE-T1WI (N–R), and FLAIR (T–X) show time-dependent changes after PDT.

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    Fig 3.

    A representative case in the non-PDT group. Preoperative DWI (A), ADC map (E), CE-T1WI (I), and FLAIR (M) demonstrate the lesion in the right temporal lobe. Postoperative DWI (B–D), ADC map (F–H), CE-T1WI (J–L), and FLAIR (N–P) show time-dependent changes after the operation.

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    Fig 4.

    Postoperative DWI (left) and ADC map (right) demonstrate representative settings for the ROIs in the PDT group (A) and non-PDT group (B). The small circles labeled 1–5 indicate the ROIs used for analysis of the ADC values. A line graph demonstrates the postoperative time-dependent change in ADC values in the PDT group (thick line) and non-PDT group (thin line) (C). Double asterisks indicate P < .01; triple asterisks, P < .001, Mann-Whitney U test.

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    Fig 5.

    DWI (A) and a schematic illustration of A (B) show the post-PDT changes in irradiated and nonirradiated areas on day 1 for 1 patient in the PDT group. The circle with the solid line indicates the area with PDT irradiation (w/PDT). The circle with the dotted line indicates the area without PDT irradiation (w/o PDT). The white arrow indicates the middle cerebral artery. The line graph shows the postoperative time-dependent changes in ADC values in areas with PDT (thick line) and without PDT (thin line) (C).

Tables

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  • Patient characteristics

    CharacteristicPDT (n = 14)Non-PDT (n = 10)P Value
    Age (yr).98
     Median (range)61.5 (35–70)61.0 (36–72)
    Sex (No.) (%).92
     Male8 (57)6 (60)
     Female6 (43)4 (40)
    Preoperative Karnofsky Performance Status Scale score.17
     Median (range)80 (30–100)70 (30–100)
    Tumor locations (No.) (%).67
     Frontal9 (64)5 (50)
     Temporal3 (21)4 (40)
     Parietal1 (7)1 (10)
     Basal ganglia1 (7)0 (0)
    Preoperative tumor volume (cm3).07
     Median (range)31.7 (2.2–140.0)70.3 (16.4–153.5)
    Extent of resection (No.) (%).91
     Gross-total10 (71)7 (70)
     Subtotal2 (14)1 (10)
     Partial2 (14)2 (20)
    Histopathology (No.) (%).14
     Glioblastoma11 (79)10 (10)
     Anaplastic astrocytoma1 (7)0 (0)
     Anaplastic oligodendroglioma2 (14)0 (0)
    Isocitrate dehydrogenase mutation status (No.) (%).50
     Wild-type11 (79)9 (90)
     Mutant3 (21)1 (10)
    MIB-1 index.65
     Median (range)20 (10–80)20 (8–40)
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American Journal of Neuroradiology: 40 (12)
American Journal of Neuroradiology
Vol. 40, Issue 12
1 Dec 2019
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Cite this article
Y. Fujita, T. Sasayama, K. Tanaka, K. Kyotani, H. Nagashima, M. Kohta, H. Kimura, A. Fujita, E. Kohmura
DWI for Monitoring the Acute Response of Malignant Gliomas to Photodynamic Therapy
American Journal of Neuroradiology Dec 2019, 40 (12) 2045-2051; DOI: 10.3174/ajnr.A6300

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DWI for Monitoring the Acute Response of Malignant Gliomas to Photodynamic Therapy
Y. Fujita, T. Sasayama, K. Tanaka, K. Kyotani, H. Nagashima, M. Kohta, H. Kimura, A. Fujita, E. Kohmura
American Journal of Neuroradiology Dec 2019, 40 (12) 2045-2051; DOI: 10.3174/ajnr.A6300
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