Document Detail


Diffusion tensor imaging tractography in patients with intramedullary tumors: comparison with intraoperative findings and value for prediction of tumor resectability.
MedLine Citation:
PMID:  20809733     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The aim of this retrospective study was to evaluate the predictive value of diffusion tensor (DT) imaging with respect to resectability of intramedullary spinal cord tumors and to determine the concordance of this method with intraoperative surgical findings. METHODS: Diffusion tensor imaging was performed in 14 patients with intramedullary lesions of the spinal cord at different levels using a 3-T magnet. Routine MR imaging scans were also obtained, including unenhanced and enhanced T1-weighted images and T2-weighted images. Patients were classified according to the fiber course with respect to the lesion and their lesions were rated as resectable or nonresectable. These results were compared with the surgical findings (existence vs absence of cleavage plane). The interrater reliability was calculated using the kappa coefficient of Cohen. RESULTS: Of the 14 patients (7 male, 7 female; mean age 49.2 +/- 15.5 years), 13 had tumors (8 ependymomas, 2 lymphomas, and 3 astrocytoma). One lesion was proven to be a multiple sclerosis plaque during further diagnostic workup. The lesions could be classified into 3 types according to the fiber course. In Type 1 (5 cases) fibers did not pass through the solid lesion. In Type 2 (3 cases) some fibers crossed the lesion, but most of the lesion volume did not contain fibers. In Type 3 (6 cases) the fibers were completely encased by tumor. Based on these results, 6 tumors were considered resectable, 7 were not. During surgery, 7 tumors showed a good cleavage plane, 6 did not. The interrater reliability (Cohen kappa) was calculated as 0.83 (p < 0.003), which is considered to represent substantial agreement. The mean duration of follow-up was 12.0 +/- 2.9. The median McCormick grade at the end of follow-up was II. CONCLUSIONS: These preliminary data suggest that DT imaging in patients with spinal cord tumors is capable of predicting the resectability of the lesion. A further prospective study is needed to confirm these results and any effect on patient outcome.
Authors:
Matthias Setzer; Ryan D Murtagh; F Reed Murtagh; Mohammed Eleraky; Surbhi Jain; Gerhard Marquardt; Volker Seifert; Frank D Vrionis
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery. Spine     Volume:  13     ISSN:  1547-5646     ISO Abbreviation:  J Neurosurg Spine     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-02     Completed Date:  2010-09-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101223545     Medline TA:  J Neurosurg Spine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  371-80     Citation Subset:  IM    
Affiliation:
H. Lee Moffitt Cancer Center and Research Institute, Neurooncology Program, 12902 Magnolia Drive, Tampa, Florida 33612, USA. frank.vrionis@moffitt.org
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MeSH Terms
Descriptor/Qualifier:
Astrocytoma / pathology,  surgery
Diffusion Tensor Imaging / instrumentation,  methods*
Ependymoma / pathology,  surgery
Female
Follow-Up Studies
Humans
Intraoperative Period
Lymphoma / pathology,  surgery
Male
Middle Aged
Multiple Sclerosis / pathology,  surgery
Neural Pathways / pathology
Observer Variation
Retrospective Studies
Spinal Cord / pathology,  surgery
Spinal Cord Neoplasms / pathology*,  surgery*
Therapy, Computer-Assisted / methods*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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