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Radiology Research and Practice
Volume 2016, Article ID 7671854, 15 pages
Research Article

Preoperative Quantitative MR Tractography Compared with Visual Tract Evaluation in Patients with Neuropathologically Confirmed Gliomas Grades II and III: A Prospective Cohort Study

1Department of Surgical Sciences, Radiology, Uppsala University, 75105 Uppsala, Sweden
2Department of Neuroradiology, Karolinska University Hospital, Department of Clinical Neuroscience, Karolinska Institute, 17177 Stockholm, Sweden
3Bioimaging Center, Lund University, 22100 Lund, Sweden
4Department of Neuroscience, Neurosurgery, Uppsala University, 75105 Uppsala, Sweden
5Department of Neuroscience, Neurology, Uppsala University, 75105 Uppsala, Sweden
6Section of Pathology, Uppsala University Hospital and Department of Immunology, Genetics and Pathology, Uppsala University, 75105 Uppsala, Sweden
7MR Department, Centre for Medical Imaging and Physiology, Lund University Hospital, 22185 Lund, Sweden

Received 14 December 2015; Accepted 23 March 2016

Academic Editor: Paul Sijens

Copyright © 2016 Anna F. Delgado et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background and Purpose. Low-grade gliomas show infiltrative growth in white matter tracts. Diffusion tensor tractography can noninvasively assess white matter tracts. The aim was to preoperatively assess tumor growth in white matter tracts using quantitative MR tractography (3T). The hypothesis was that suspected infiltrated tracts would have altered diffusional properties in infiltrated tract segments compared to noninfiltrated tracts. Materials and Methods. Forty-eight patients with suspected low-grade glioma were included after written informed consent and underwent preoperative diffusion tensor imaging in this prospective review-board approved study. Major white matter tracts in both hemispheres were tracked, segmented, and visually assessed for tumor involvement in thirty-four patients with gliomas grade II or III (astrocytomas or oligodendrogliomas) on postoperative neuropathological evaluation. Relative fractional anisotropy (rFA) and mean diffusivity (rMD) in tract segments were calculated and compared with visual evaluation and neuropathological diagnosis. Results. Tract segment infiltration on visual evaluation was associated with a lower rFA and high rMD in a majority of evaluated tract segments (89% and 78%, resp.). Grade II and grade III gliomas had similar infiltrating behavior. Conclusion. Quantitative MR tractography corresponds to visual evaluation of suspected tract infiltration. It may be useful for an objective preoperative evaluation of tract segment involvement.