Grading of Glioma Tumors by Analysis of Minimum Apparent Diffusion Coefficient and Maximum Relative Cerebral Blood Volume

Background: Gliomas are the most common primary neoplasms of thecentral nervous system. Relative cerebral blood volume (rCBV) couldestimate high-grade Gliomas computed with dynamic susceptibility contrastMR imaging which it is artificially lowered by contrast extravasation througha disrupted blood-brain barrier.Objectives: Our intent was to clarify the usefulness of diffusion-weightedmagnetic resonance imaging (DWI) and perfusion weighted magneticresonance imaging (PWI) in the grading of Gliomas.Materials and Methods: Both PWI and DWI with a three-tesla scannerinvestigated nineteen consecutive patients with Gliomas. The means of rCBVand ADC values have been compared among the tumor groups with t-test andROC curve analysis to determine threshold values of Gliomas grading.Results: Mean maximum rCBV were 2.71±1.41 for low grades (I & II), and8.14±2.58 for high grades (III & IV) Gliomas (p=0.001). Mean minimumADC were 1.47±.46 ×103 mm2/s for low grades (I & II), and .47±.38×103mm2/s for high grades (III & IV) Gliomas (p=0.001). We can get 0.94×103mm2/s for minimum ADC and 3.85 for maximum rCBV as a difference cutoffpoint between low and high-grade Gliomas.Conclusion: Combination of both DWI and PWI techniques, withmeasurement of minimum ADC and maximum rCBV can be used todistinguish between high grade and low-grade Glioma tumors.

Grading of Glioma Tumors by Analysis of Minimum Apparent Diffusion Coefficient and Maximum Relative Cerebral Blood Volume Keywords:

Diffusion Magnetic Resonance Imaging , Neoplasm Grading