Potential role of quantitative MRI assessment in differentiating high from low-grade gliomas

AbstractBackgroundIt is crucial to accurately differentiate HGGs from LGGs, as treatment strategies vary. Our study aims to assess the sensitivity and specificity of fractional anisotropy (FA) values derived from diffusion tensor imaging (DTI) and dynamic contrast enhanced perfusion-weighted imaging (PWI) in differentiating HGGs from LGGs.Materials15 patients with HGGs and 9 LGGs were examined. Mean, Minimal and Maximal FA fractional anisotropy in tumour, necrotic area and in surrounding oedema, as well as (rCBV) ratio of the lesions were measured and compared between LGG and HGG. The efficacy of the above parameters in grading gliomas was evaluated. In perfusion MRI, we measure rCBV ratio as parameter of neovascularity of tumour.ResultsThe use of MR DTI had an important role in the grading of brain gliomas as it was accurate in grading 24 cases. There was significant correlation between histopathological grade and FA values measured in tumour and necrotic areas. No positive correlation in perifocal areas could be established. Our results show significant difference between HGG and LGG with mean rCBV ratio as 2.62 & 0.79 with best cut-off value (1.2).Combined use of MR DTI and MR perfusion added to the accuracy of grading of glioma