A BSTRACT Background: Magnetic resonance imaging (MRI) is essential for evaluating intracranial tumors, but conventional MRI is inadequate for assessing tumor grade or infiltration. Advanced MR sequences like diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) can differentiate between low- and high-grade tumors. This study aims to evaluate the effectiveness of DWI and MRS for grading intra-axial brain tumors. Methods: This observational study involved 36 patients suspected of having brain tumors. The study used conventional MRI sequences along with DWI and MRS to measure apparent diffusion coefficient (ADC) values and choline/creatine-phosphocreatine complex (Cho/Cr), choline/N-acetyl aspartate (Cho/NAA), and N-acetyl aspartate/creatine-phosphocreatine complex ratios. Results from these variables were compared with histopathology examination. Results: On histopathological examination, high-grade glioma (HGG) was diagnosed in 19 (52.8%) patients, while low-grade glioma (LGG) and metastatic tumors were diagnosed in 10 (27.8%) and 7 (19.4%) patients, respectively. The study findings demonstrated significant differences in ADCt (0.73 vs. 1.2 × 10-3 mm 2 /s), ADCt/n (0.92 vs. 1.40 × 10-3 mm 2 /s), tumor Cho/Cr (5.247 vs. 3.121) and Cho/NAA (6.833 vs. 4.352), and peritumoral edema Cho/Cr (1.989 vs. 1.236) and Cho/NAA (2.083 vs. 0.825) between HGG versus LGG ( P < 0.05). Similarly, peritumoral edema Cho/Cr (1.989 vs. 1.09) and Cho/NAA (2.083 vs. 0.899) showed significant differences in HGG versus metastasis ( P < 0.05). Our findings show that DWI and MRS can be used together to distinguish between HGG and LGG with a sensitivity of 100% and a specificity of 80%. Conclusion: MR spectroscopy combined with DWI with computation of ADC values can enhance the diagnostic effectiveness of MRI in detecting and grading intra-axial brain tumors.
Kadian et al. (Mon,) studied this question.
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