application of advanced mri techniques in patients affected by meningioma treated with protontherapy
PO-1855
Abstract
application of advanced mri techniques in patients affected by meningioma treated with protontherapy
Authors: Luca Anemoni1, Ivonne Elenoire Mascayano1, Lorenzo Preda2, Ester Orlandi1, Margherita Sofia Cadeo1, Alice Mancin1, Maria Elena Piazzolla1, Sara Tampellini1
1Fondazione CNAO, Radiotherapy, Pavia, Italy; 2IRCCS Ospedale San Matteo, Radiology, Pavia, Italy
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Purpose or Objective
In the panorama of advanced
magnetic resonance imaging (MRI) techniques, Diffusion Weighted Imaging (DWI)
proved to be a valuable diagnostic tool in the neuro-oncologic field: a recent development of Diffusion
Imaging is represented by the Intravoxel Incoherent Motion technique (IVIM)
which allows to study,in a more specific way, the diffusivity of the tissues of
an organism, also taking into account
their vascular micro-perfusivity.The following work carried out aims to verify through the processing of data
obtained from imaging techniques DWI-MRI and IVIM-MRI to detect early changes in diffusion, preudo-diffusion and perfusion properties of normal tissue in patients affected by meningioma.
Material and Methods
Quantitative data set related to
the diffusiveness of the healthy white matter (WM) of ten patients suffering
from anaplastic meningioma treated with Protontherapy before the start of
treatment and in the follow-up at 3, 6 and 9 months after the end of the
treatment were analysed.
The data were collected in post-processing using a specific software from
multiparametric maps (ADC, D, D* and f) in turn extrapolated from DWI-MRI
sequences, obtaining for each patient the total number of WM voxels contoured,
the total volume included in the contours (mm3) and the average
intensity of voxels with the relative standard deviation DS (σ).
Results
The results obtained concerning
the mean intensity values (mm2/s) of ADC, D, D* and f show a
homogeneous trend both in comparison of these for each patient and among the
ten patients examined, with small discrepancies between them: ADC= 0,79x10-3 mm2/s
(±150,3628 mm2/s); D= 0,70×10−3 mm2/s (±159,0189mm2/s);
D*= 1,3×102 mm2/s (±0,0335 mm2/s); f= 1,1x10 mm2/s
(±0,1052 mm2/s). D is similar to ADC, but it's larger as it takes
into account, as a loss contribution to the signal , not only perfusion but
also the effect of diffusion; D*, as a result of microperfusion in
capillaries is shown to be greater than D. D* as well as f, due to the
inability of the MRI scanner to acquire images at low b-values (0-50 s/mm2),
where micro-perfusion gives a greater contribution to signal loss than
diffusion, could provide less accurate data than desirable.
Conclusion
In conclusion, it was observed
that the ADC value obtained from DWI sequences is (0.79x10-3 mm2/s) in line with the
expected values in the literature of neuro-oncological studies
(0,319–1,05×10−3mm2/s). In
ight of these considerations, it is to be hoped that DWI-MRI and IVIM-MRI
techniques, which are so promising in the MRI approach, will contribute more
and more to diagnostic improvement, both in the field of research and clinics.