Detection of tumour infiltration in axonal fibre bundles using diffusion tensor imaging.

We present a method for the detection and quantification of white matter infiltration from human brain tumours based on Diffusion Tensor Imaging (DTI). Since white matter destruction alters the local diffusion properties, DTI has the potential to sensitively detect tumour infiltration and to quantify the degree thereof. Here, we consider three tumour patients with gliomas, two with and one without contralateral tumour progress. We use DTI to identify specific fibre systems, where infiltration has to be assessed. On this basis, the problem of arbitrary region of interest definition is solved such that tumour infiltration can be reliably quantified in particular fibre bundles. It is demonstrated at the Corpus Callosum (CC) and the Pyramidal Tract (PT) that fibre bundle infiltration can be well detected by specific visualisation techniques of diffusion tensor data. Infiltration of the CC is quantified by using a reliable method for the determination of diffusion properties inside particular fibre bundles. For an age normalised quantification of white matter infiltration we introduce the Integrity Index, which measures the diffusion anisotropy inside an infiltrated fibre bundle normalised by the diffusion anisotropy in a specific region of healthy fibre tissue. It turns out that the quantification of CC infiltration correlates with contralateral tumour progression and has the potential to serve as a surrogate marker for this process, which is crucial for surgical therapy decisions and intervention planning. Copyright 2005 John Wiley & Sons, Ltd.