“EFFICACY OF DIFFUSION WEIGHTED IMAGING AND MR SPECTROSCOPY IN DIFFERENTIATION AND GRADING OF BRAIN TUMORS”
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Keywords
Brain tumors, Diffusion Weighted Imaging (DWI), MR Spectroscopy (MRS), Tumor grading, Multiparametric MRI
Abstract
Objective: To evaluate the efficacy of Diffusion Weighted Imaging (DWI) and MR Spectroscopy (MRS) in differentiating and grading brain tumors.
Methods: This prospective observational study included 100 patients with suspected brain tumors. All patients underwent conventional MRI, DWI, and MRS. Diagnostic performance was assessed for DWI and MRS individually and in combination, using histopathology as the gold standard. ADC values and metabolite ratios (Cho/NAA, Cho/Cr) were analyzed for different tumor types and grades. ROC analysis was performed to determine optimal diagnostic thresholds.
Results: The combined DWI and MRS approach showed the highest diagnostic accuracy (90%) in differentiating high-grade from low-grade tumors, compared to DWI (80%) or MRS (83%) alone. High-grade gliomas and metastases demonstrated lower ADC values (0.85 ± 0.18 and 0.76 ± 0.15 × 10^-3 mm^2/s, respectively) compared to low-grade gliomas (1.28 ± 0.22 × 10^-3 mm^2/s). Cho/NAA and Cho/Cr ratios were elevated in high-grade tumors. Meningiomas showed distinctively high Cho/Cr ratios (7.3 ± 1.2). ROC analysis revealed good discriminatory power for ADC values (AUC = 0.85) and metabolite ratios (AUC = 0.86-0.88) in tumor grading.
Conclusion: The combination of DWI and MRS significantly improves the accuracy of brain tumor differentiation and grading compared to either technique alone. These advanced MRI techniques provide valuable complementary information to conventional MRI, potentially enhancing diagnostic confidence and treatment planning in neuro-oncology.
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Dr. Shashi Kant
Assistant Professor, Department of Radio- Diagnosis, United Institute of Medical Sciences, Prayagraj, Uttar Pradesh, India