OBJECTIVES: Glucocorticoids (dexamethasone) are thought to reduce peritumoural brain oedema by decreasing the permeability of neoplastic capillaries and/or enhancing the clearance of extracellular water. Diffusion tensor magnetic resonance imaging (DT-MRI) was used to measure the water diffusion parameters of oedematous and normal brain in a group of patients with intracranial tumours before and after steroid treatment. METHODS: Fifteen patients with intracranial tumours (seven with high-grade glioma, four with metastatic carcinoma and four with meningioma) were examined before and 48-72 h after dexamethasone treatment (16 mg/day). The mean diffusivity (<D>) and fractional anisotropy (FA) were measured for oedematous brain and apparently normal contralateral white matter before and after steroid therapy. RESULTS: In all three patient groups there was a significant decrease in <D> of oedematous brain after steroid treatment (p<0.01). There was no significant change in FA of oedematous brain after treatment in any of the three groups. There was also no significant change in either <D> or FA of apparently normal contralateral white matter after treatment. CONCLUSION: These data indicate that dexamethasone produces a localised reduction in the magnitude of extracellular water molecule mobility, and hence water content, in peritumoural oedematous brain. Furthermore, the magnitude of these changes is similar for both intra- and extra-axial tumours.
OBJECTIVES: Glucocorticoids (dexamethasone) are thought to reduce peritumoural brain oedema by decreasing the permeability of neoplastic capillaries and/or enhancing the clearance of extracellular water. Diffusion tensor magnetic resonance imaging (DT-MRI) was used to measure the water diffusion parameters of oedematous and normal brain in a group of patients with intracranial tumours before and after steroid treatment. METHODS: Fifteen patients with intracranial tumours (seven with high-grade glioma, four with metastatic carcinoma and four with meningioma) were examined before and 48-72 h after dexamethasone treatment (16 mg/day). The mean diffusivity (<D>) and fractional anisotropy (FA) were measured for oedematous brain and apparently normal contralateral white matter before and after steroid therapy. RESULTS: In all three patient groups there was a significant decrease in <D> of oedematous brain after steroid treatment (p<0.01). There was no significant change in FA of oedematous brain after treatment in any of the three groups. There was also no significant change in either <D> or FA of apparently normal contralateral white matter after treatment. CONCLUSION: These data indicate that dexamethasone produces a localised reduction in the magnitude of extracellular water molecule mobility, and hence water content, in peritumoural oedematous brain. Furthermore, the magnitude of these changes is similar for both intra- and extra-axial tumours.
Authors: Inas S Khayal; Mei-Yin C Polley; Llewellyn Jalbert; Adam Elkhaled; Susan M Chang; Soonmee Cha; Nicholas A Butowski; Sarah J Nelson Journal: Neuro Oncol Date: 2010-05-25 Impact factor: 12.300
Authors: Nils D Arvold; Terri S Armstrong; Katherine E Warren; Susan M Chang; Lisa M DeAngelis; Jaishri Blakeley; Marc C Chamberlain; Erin Dunbar; Herbert H Loong; David R Macdonald; David A Reardon; Michael A Vogelbaum; Ying Yuan; Michael Weller; Martin van den Bent; Patrick Y Wen Journal: Neuro Oncol Date: 2018-06-18 Impact factor: 12.300
Authors: S J Price; R Jena; N G Burnet; P J Hutchinson; A F Dean; A Peña; J D Pickard; T A Carpenter; J H Gillard Journal: AJNR Am J Neuroradiol Date: 2006-10 Impact factor: 3.825