MR imaging methods such as DWI and DTI based on tissue biophysical properties are rapidly being incorporated in routine brain imaging protocols to improve the diagnosis, characterization, and management of patients with brain tumors. In the future, these methods combined with other physiology-based methods, such as MR perfusion and MRS metabolite mapping, as well as excellent anatomic images are anticipated to improve brain tumor diagnosis, biopsy guidance, pretreatment and presurgical planning, and the assessment of therapeutic efficacy in individuals. In their current form, DWI and DTI yield remarkable insight into tissue and tumor cellularity and organization in a totally noninvasive fashion. In the future, more sophisticated forms of diffusion-based image acquisition and analysis may increase the specificity of these approaches. Existing studies demonstrate that DWI and DTI are indicators of tumor cell density and microstructural organization. Further research is needed to determine how to best use diffusion information to impact positively patient management. © 2006 Elsevier Inc. All rights reserved.
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