Assessment of therapeutic response in patients with brain abscess using diffusion tensor imaging

World Neurosurg. 2010 Jan;73(1):63-8; discussion e6. doi: 10.1016/j.surneu.2009.04.003. Epub 2009 Aug 7.

Abstract

Background: Accurate assessment of therapeutic response in patients with brain abscess (BA) is essential to direct appropriate therapy. This study was performed with an aim to see the treatment-induced changes in diffusion tensor imaging (DTI) indices (i.e., fractional anisotropy [FA] and mean diffusivity [MD]) in follow-up patients with BA after treatment.

Methods: Twenty patients with BA were prospectively studied in this study. Diffusion tensor imaging in first follow-up was done in all after 1 week and in 6 at 4 weeks of the initial study.

Results: The mean FA and MD values in first, second, and third studies were 0.28 +/- 0.03 and (0.81 +/- 0.07) x 10(-3) mm(2)/s, 0.18 +/- 0.09 and (1.08 +/- 0.09) x 10(-3) mm(2)/s, and 0.13 +/- 0.04 and (0.99 +/- 0.13) x 10(-3) mm(2)/s, respectively. The FA value was significantly (P < .01) decreased along with no significant change in MD value (P = .08) for 3 study periods. The mean volume (in milliliter) of the abscesses was 2.14 +/- 1.04, 1.34 +/- 0.45, and 0.77 +/- 0.14 in first, second, and third studies, respectively.

Conclusions: We conclude that the reduction in FA value reflects the down-regulation of the neuroinflammatory molecules in response to treatment in patient with BA and may be used to assess therapeutic response in these patients in future.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anisotropy
  • Anti-Bacterial Agents / therapeutic use
  • Brain Abscess / metabolism
  • Brain Abscess / pathology*
  • Brain Abscess / therapy*
  • Child
  • Cytokines / physiology
  • Diffusion Tensor Imaging*
  • Drainage
  • Follow-Up Studies
  • Humans
  • Predictive Value of Tests
  • Prospective Studies
  • Stereotaxic Techniques
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Cytokines