Imaging White Matter Architecture and its Relationship to Tumor Growth Using Diffusion Tensor Imaging

Susumu Mori, Ph.D.

Johns Hopkins University, Baltimore, MD

Grant Program:

David Mahoney Neuroimaging Program

Funded in:

February 2002, for 5 years

Funding Amount:

$100,000

Investigator Biographies

Susumu Mori, Ph.D.

Assistant Professor, Johns Hopkins University

Hypothesis

Hypothesis:
1. DTI can delineate detailed anatomy of white matter tracts deformed by tumor growth.
2. DTI provides information about whether tumors are growing by expansion or by infiltration into specific white matter tracts.
3. If the tumor is infiltrating type, it tends to grow along white matter tracts.

Goals:
The long-term goal of this project is to confirm the hypothesis that DTI can delineate the relationship between brain tumors and adjacent white matter tracts, providing information for preoperative planning that will lead to improved surgical outcomes. In order to achieve this goal, we propose the following three specific aims.

Aim 1: Develop an optimized imaging protocol for DTI
Aim 2: Build a preliminary database of DTI scans of patients with brain tumors
Aim 3: Perform 2D and 3D anatomical analyses of prominent white matter tracts and analyze the growth of the tumor with respect to adjacent white matter tracts

Methods:
To confirm these two preliminary hypotheses, we propose three-step approach. In the first step (Aim 1), we will optimize data acquisition techniques for the DTI. The second step (Aim 2) is to build a preliminary database of DTI scans of brain tumor patients. During this grant period (3 years), we will recruit 12 patients with diagnosed malignant gliomas (grades II-IV) in each year. In the third step (Aim 3), relationship between the tumor growth and adjacent white matter tracts will be examined. In this step, white matter anatomy is examined by 2D or 3D based tract reconstruction / visualization techniques.

Findings:
We established protocols that can be used to reproducibly reconstruct 12 major white matter tracts in the human brain (Aim 1). The DTI database of tumor patients now includes data from 46 patients. Currently we are applying the common tractography protocol to these data to evaluate how reliably white matter tracts can be reconstructed in tumor patients with altered white matter anatomy.

Selected Publications

Wakana S., Caprihan A., Panzenboeck M.M., Fallon J.H., Perry M., Gollub R.L., Hua K., Zhang J., Dubey P., Blitz A., van Zijl, P.C., and Mori S. “Reproducibility of quantitative tractography methods applied to cerebral white matter.” Neuroimage. 2007 Jul 1;36(3):630-44 .

Mori S., Frederiksen K., van Zijl P.C., Stieltjes B., Kraut M.A., Solaiyappan M., and Pomper M.G. Brain white matter anatomy of tumor patients evaluated with diffusion tensor imaging. Ann Neurol. 2002 Mar;51(3):377-80 .

Mori S., Kaufmann W.E., Davatzikos C., Stieltjes B., Amodei L., Fredericksen K., Pearlson G.D., Melhem E.R., Solaiyappan M., Raymond G.V., Moser H.W., and van Zijl P.C. Imaging cortical association tracts in the human brain using diffusion-tensor-based axonal tracking. Magn Reson Med. 2002 Feb;47(2):215-23 .

Mori S., Crain B.J., Chacko V.P., and van Zijl P.C. Three-dimensional tracking of axonal projections in the brain by magnetic resonance imaging. Ann Neurol. 1999 Feb;45(2):265-9.

Stieltjes B., Kaufmann W.E., van Zijl P.C.M., Fredericksen K., Pearlson G.D., and Mori S. Diffusion tensor imaging and axonal tracking in the human brainstem. Neuroimage. 2001 Sep;14(3):723-35 .