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Abstract

Objectives: The purpose of our study was to determine the role of mean apparent diffusion coefficient (ADC) values in differentiating low-grade from high-grade gliomas, keeping conventional MRI sequences as a gold standard
Methods: This study was done in Lady Reading Hospital from September 2022 to December 2023. The prospective cross-sectional descriptive study included patients from the Out-Patient Department and Neurosurgery wards. Patients underwent MRI on a 1.5 Tesla machine, acquiring T2WI, T1WI, FLAIR, DWI, and gadolinium-enhanced T1WI sequences. PACS software identified areas with restricted diffusion and low ADC values. ROI measurements were made to determine ADC values. Image artifacts and contrast enhancement patterns were noted. Data on patient demographics, lesion location, MRI features, and ADC values were analyzed with SPSS-23.
Results: A total of 104 patients were included, with ages ranging from 3–87 years (Mean 41 years, ± 19.5), with 62 having low-grade gliomas and 42 high-grade gliomas. The mean ADC values were 1334.37 ± 300.85 mm2/s for low-grade and 842.88 ± 232.013 mm2/s for high-grade gliomas. The sensitivity and specificity of low ADC for high-grade glioma are 83.33 % and 77.42%, respectively. The optimal ADC cut of 1086.58 mm2/s significantly correlated with glioma grading (p < 0.001). Multiple linear regression revealed a significant relationship (p < 0.001) between mean ADC and tumor enhancement. Notable associations between ADC cut-off and enhancement were identified (p = 0.001).
Conclusion: The ADC values serve as a non-invasive and reliable radiological marker in distinguishing low-grade and high-grade gliomas. They improve the diagnostic accuracy of conventional MRI and aid in preoperative decision-making, reducing the need for invasive tissue biopsy.
Keywords:
ADC, gliomas, MRI, peritumoral edema, tumor enhancement.