Free water elimination tractometry reveals local and remote white matter alterations in diffuse gliomas
Year: 2025
Type: article
Study design: Observational Study
Abstract: PURPOSE: To apply free water elimination (FWE) tractometry to a real-world clinical imaging dataset to quantify pathology-specific patterns of white matter involvement and peritumoral tissue alterations in diffuse gliomas. METHODS: The University of California San Francisco Preoperative Diffuse Glioma MRI dataset was analyzed using FWE tractometry. Twenty major white matter tracts were reconstructed and each divided into 100 equidistant nodes. Direct tumor involvement was quantified across enhancing tumor, necrotic core, and edema regions. Remote white matter tissue properties were assessed through hemispheric asymmetry analysis of free water-corrected fractional anisotropy (FW-FA), mean diffusivity (FW-MD), and free water fraction (FWF) in non-tumor involved regions at standardized distances from radiological tumor margins. RESULTS: 459 patients with unilateral glioma were included (361 glioblastoma, 87 astrocytoma, 11 oligodendroglioma). Glioblastoma demonstrated greater direct white matter involvement in enhancing tumor and necrotic core compared to astrocytoma and oligodendroglioma (q < 0.001, q = 0.01, respectively). Beyond radiological tumor margins, glioblastoma and astrocytoma exhibited decreased FW-FA, while oligodendroglioma showed increased FW-FA (q = 0.008, q = 0.04, respectively). Distance-based analysis revealed that this effect was most prominent in the proximal peritumoral region and diminished with increasing distance from tumor margins. CONCLUSION: Using FWE tractometry on a large clinical repository, we identified distinct pathology-specific patterns of white matter alteration. Glioblastoma showed extensive direct involvement and peritumoral microstructural changes, while oligodendroglioma demonstrated relatively preserved white matter architecture near tumor margins. These patterns reflect expected biological differences and provide a reproducible framework for characterizing extent of white matter involvement, with potential applications in presurgical planning and understanding recurrence patterns.
Source: Journal of Neuro-Oncology
Institutions: University of Pennsylvania, University of Washington
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,590
Funders: National Science Foundation, Alfred P. Sloan Foundation, Gordon and Betty Moore Foundation, Epilepsy Society, National Institutes of Health, University of California, San Francisco, National Institute on Aging, National Institute of Mental Health, National Eye Institute, National Institute of Neurological Disorders and Stroke, National Institute of Biomedical Imaging and Bioengineering
Awards: A data science toolbox for analysis of Human Connectome Project diffusion MRI, G2483934608, Scalable methods to quantify epileptic network and guide epilepsy surgery, Remapping Clinical Neuroscience through Translation and Innovation Training (ReCoNnecT-IT), HDR: I-DIRSE-FW: Accelerating the Engineering Design and Manufacturing Life-Cycle with Data Science, Adult Changes in Thought (ACT) Research Program, CRCNS: A computational approach to map visual cortex organization in the human brain, Community-supported open-source software for computational neuroanatomy, University of Washington Alzheimer's Disease Research Center, Aging eyes and aging brains in studying alzheimer''s disease: Modern ophthalmic data collection in the adult changes in thought (ACT) study
OpenAlex ID: W4417199035