• World Neurosurg · Sep 2017

    Subventricular zone involvement characterised by DTI in glioblastoma.

    • Bart R J van Dijken, Jiun-Lin Yan, Natalie R Boonzaier, Chao Li, Peter Jan van Laar, Anouk van der Hoorn, and Stephen J Price.
    • Brain Tumour Imaging Laboratory, Division of Neurosurgery, Department of Clinical Neuroscience, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom; Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: b.r.j.van.dijken@student.rug.nl.
    • World Neurosurg. 2017 Sep 1; 105: 697-701.

    BackgroundGlioblastomas have a poor prognosis, possibly because of a subpopulation of therapy-resistant stem cells within the heterogeneous glioblastoma. Because the subventricular zone is the main source of neural stem cells, we aimed at characterizing the subventricular zone using diffusion tensor imaging (DTI) to show subventricular zone involvement in glioblastoma.MethodsWe prospectively included 93 patients with primary glioblastomas who underwent preoperative DTI. The nonenhancing high fluid-attenuated inversion recovery (FLAIR) signal was used to describe the infiltrative tumor margin. We used a 5-mm margin surrounding the lateral ventricles to define the subventricular zone. The subventricular zone with high FLAIR was compared with the subventricular zone without high FLAIR, control high FLAIR outside the subventricular zone and control contralateral normal-appearing white matter. Normalized DTI parameters were calculated and compared between the different regions.ResultsThe subventricular zone with high FLAIR showed increased isotropic p values compared with the subventricular zone without high FLAIR (t126 = 3.9; P < 0.001) and control regions (t179 = 1.9; P = 0.046). Anisotropic q and fractional anisotropy values were lower in regions with high FLAIR compared with the subventricular zone without high FLAIR (t181 = 11.6, P < 0.001 and t184 =12.4, P < 0.001, respectively).ConclusionDTI data showed that the subventricular zone is involved in glioblastoma with increased isotropic p values in the subventricular zone with high FLAIR, indicating tumor infiltration.Copyright © 2017 Elsevier Inc. All rights reserved.

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