Role of Multivoxel Intermediate TE 2D CSI MR Spectroscopy and 2D Echoplanar Diffusion Imaging in Grading of Primary Glial Brain Tumours
Introduction: Preoperative tumour grading is imperative owing to difference in invasive, aggressive tendencies of different grades of glial tumours implying varied prognosis, therapeutic options. Histopathological examination has inherent sampling errors. Magnetic Resonance Spectroscopy (MRS) an...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2017-06-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/9984/24982_CE[Ra]_F(Sh)_PF1(SY_SS)_PFA(SY_SS).pdf |
| Summary: | Introduction: Preoperative tumour grading is imperative owing
to difference in invasive, aggressive tendencies of different
grades of glial tumours implying varied prognosis, therapeutic
options. Histopathological examination has inherent sampling
errors. Magnetic Resonance Spectroscopy (MRS) and Diffusion
Weighted Imaging (DWI) can provide non invasive information
about internal mileu hence, aiding in tumour grading by adding
to information provided by conventional MRI sequences.
Aim: To evaluate the role of multivoxel intermediate TE 2D CSI
MRS and 2D echoplanar diffusion imaging in grading of primary
glial brain tumours.
Material and Methods: A prospective study was conducted
in Department of Radiology, Teerthanker Mahaveer Medical
College and Research Centre, Uttar Pradesh, India, from April
2015 to August 2016 after obtaining necessary approvals from
Institutional Ethical Committee and written informed consent
from all participants on histopathological proven cases of
glial brain tumours that underwent multivoxel MRS using
intermediate TE 2D chemical shift imaging and DWI using 2D
echoplanar imaging. Tumour grade calculated on MRI using
MRS and DWI was compared with histopathological grading.
Positive Predictive Value (PPV), Negative Predictive Value (NPV),
Sensitivity, specificity and accuracy were calculated for each
parameter and statistical significance was evaluated using two
tailed Pearson test.
Results: Choline: N Acetyl aspartate (Cho: NAA) and Choline:
creatinine (Cho: Cr) ratios from MRS as well as Apparent
Diffusion Coffecient (ADC) values from DWI were significantly
higher with increasing severity of tumour grade. Accuracy of
58.6% was obtained with DWI while it was 83% with MRS.
MRS and DWI used together provided 88.4% accuracy. All
parameters evaluated showed statistical significance.
Conclusion: Both DWI as well as MRS were found to have
statistically significant roles in grading of glial brain tumours.
MRS was found to be more useful than DWI. |
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| ISSN: | 2249-782X 0973-709X |