ArticleCancer imaging : the official publication of the International Cancer Imaging Society2025
Glymphatic system dysfunction and cerebrospinal fluid retention in gliomas: evidence from perivascular space diffusion and volumetric analysis.
Article in Cancer imaging : the official publication of the International Cancer Imaging Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Glymphatic system dysfunction in central nervous system malignancies: A narrative review.Neurosurgical review · 2026Review
- Leptomeningeal fibroblasts promote glioblastoma progression by regulating cerebrospinal fluid dynamics.Nature communications · 2026Article
- DTI-ALPS is not independently associated with overall survival beyond established prognostic factors in glioblastoma.Journal of neuro-oncology · 2026Article
- Vascular permeability mediates contralateral glymphatic dysfunction across glioma grades and IDH status.Neuroradiology · 2026Article
- Diffusion tensor image analysis along the perivascular space may serve as a potential biomarker for differentiating glioma recurrence from pseudoprogression: a preliminary study.Quantitative imaging in medicine and surgery · 2026Article
- Altered perivascular diffusivity in glioblastoma: integrating DTI-ALPS index with radio-pathomic and histopathologic correlates.Journal of neuro-oncology · 2026Article
- Contralateral neurofluid dynamics predict survival in IDH wild-type glioblastoma: A DTI-ALPS and free water imaging study.Neuro-oncology · 2026Article
- Prediction of glioma-related epilepsy by Brain Age Index: a multicenter study.Frontiers in neuroscience · 2026Article
- Altered Perivascular Diffusivity in Glioblastoma:Integrating DTI-ALPS Index with Radio-Pathomicand Histopathologic Correlates.Research square · 2025Article
- Aquaporin-4 in glioblastoma: a nexus of glymphatic dysfunction, edema, immune evasion, and treatment resistance.Frontiers in cellular neuroscience · 2025Review
- Immune effector cell-associated neurotoxicity syndrome: integrative mechanisms, predictive biomarkers, and translational pathways for prevention in CAR T-cell therapy.Frontiers in neurologyReview
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Abstract
backgroundGliomas may impair glymphatic function and alter cerebrospinal fluid (CSF) dynamics through structural brain changes, potentially affecting peritumoral brain edema (PTBE) and fluid clearance. This study investigated the impact of gliomas on glymphatic system function and CSF volume via diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) and volumetric magnetic resonance imaging (MRI), which clarified the relationships between tumor characteristics and glymphatic system disruption.
methodsIn this prospective study, 112 glioma patients and 56 healthy controls underwent MRI to calculate DTI-ALPS indices and perform volumetric analyses of CSF, tumor, and PTBE. Statistical analyses were used to assess the relationships between the DTI-ALPS index, tumor volume, PTBE volume, and clinical characteristics.
resultsGlioma patients had significantly lower DTI-ALPS indices (1.266 ± 0.258 vs. 1.395 ± 0.174, p < 0.001) and greater CSF volumes (174.53 ± 34.89 cm³ vs. 154.25 ± 20.89 cm³, p < 0.001) than controls did. The DTI-ALPS index was inversely correlated with tumor volume (r = -0.353, p < 0.001) and PTBE volume (r = -0.266, p = 0.015). High-grade gliomas were associated with lower DTI-ALPS indices and larger PTBE volumes (all p < 0.001). Tumor grade emerged as an independent predictor of the DTI-ALPS index in multivariate analysis (β = -0.244, p = 0.011).
conclusionGliomas are associated with significant glymphatic dysfunction, as evidenced by reduced DTI-ALPS indices and increased CSF and PTBE volumes. The DTI-ALPS index serves as a potential biomarker of glymphatic disruption in glioma patients, offering insights into tumor-related fluid changes and the pathophysiology of brain-tumor interactions.
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