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A comparative study of diffusion kurtosis imaging and diffusion tensor imaging in detecting corticospinal tract impairment in diffuse glioma patients

  • Advanced Neuroimaging
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Abstract

Purpose

This study aimed to investigate the diagnostic performance of diffusion kurtosis imaging (DKI) and diffusion tensor imaging (DTI) in identifying aberrations in the corticospinal tract (CST), whilst elucidating the relationship between abnormalities of CST and patients’ motor function.

Methods

Altogether 21 patients with WHO grade II or grade IV glioma were enrolled and divided into Group 1 and Group 2, according to the presence or absence of preoperative paralysis. DKI and DTI metrics were generated and projected onto the CST. Histograms of the CST along x, y, and z axes were developed based on DKI and DTI metrics, and compared subsequently to determine regions of aberrations on the fibers. The receiver operating characteristic curve was performed to investigate the diagnostic efficacy of DKI and DTI metrics.

Results

In Group 1, a significantly lower fractional anisotropy, radial kurtosis and mean kurtosis, and a higher mean diffusivity were found in the ipsilateral CST as compared to the contralateral CST. Significantly higher relative axial diffusivity, relative radial diffusivity, and relative mean diffusivity (rMD) were found in Group 1, as compared to Group 2. The relative volume of ipsilateral CST abnormalities higher than the maximum value of mean kurtosis combined with rMD exhibited the best diagnostic performance in distinguishing dysfunction of CST with an AUC of 0.93.

Conclusion

DKI is sensitive in detecting subtle changes of CST distal from the tumor. The combination of DKI and DTI is feasible for evaluating the impairment of the CST.

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Acknowledgements

None.

Funding

This study was supported by the Science and Technology Program of Guangzhou, China (grant number 202201011244).

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Author notes

  1. Xinman Liu and Shanmei Zeng contributed equally to the study.

Authors and Affiliations

  1. Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangdong Province, Guangzhou, China

    Xinman Liu, Xinjian Wu & Nu Zhang

  2. Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong Province, Guangzhou, China

    Shanmei Zeng, Zhiyun Yang & Jing Zhao

  3. Department of Informatics, The First Affiliated Hospital of Sun Yat-sen University, Guangdong Province, Guangzhou, China

    Tao Tao

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  1. Xinman Liu
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Correspondence to Jing Zhao or Nu Zhang.

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Liu, X., Zeng, S., Tao, T. et al. A comparative study of diffusion kurtosis imaging and diffusion tensor imaging in detecting corticospinal tract impairment in diffuse glioma patients. Neuroradiology 66, 785–796 (2024). https://doi.org/10.1007/s00234-024-03332-z

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