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

BackgroundAccurate 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 (ie, fractional anisotropy [FA] and mean diffusivity [MD]) in follow-up patients with BA after treatment.MethodsTwenty 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.ResultsThe mean FA and MD values in first, second, and third studies were 0.28 ± 0.03 and (0.81 ± 0.07) × 10−3 mm2/s, 0.18 ± 0.09 and (1.08 ± 0.09) × 10−3 mm2/s, and 0.13 ± 0.04 and (0.99 ± 0.13) × 10−3 mm2/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.ConclusionsWe 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.