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...

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Main Authors: Abhishek Aggarwal, Pankaj Kumar Das, Arvind Shukla, Sagar Parashar, Mohini Choudhary, Arpit Kumar, Narendra Kumar, Shyamoli Dutta
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2017-06-01
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
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author Abhishek Aggarwal
Pankaj Kumar Das
Arvind Shukla
Sagar Parashar
Mohini Choudhary
Arpit Kumar
Narendra Kumar
Shyamoli Dutta
author_facet Abhishek Aggarwal
Pankaj Kumar Das
Arvind Shukla
Sagar Parashar
Mohini Choudhary
Arpit Kumar
Narendra Kumar
Shyamoli Dutta
author_sort Abhishek Aggarwal
collection DOAJ
description 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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spelling doaj.art-13f0f1dd39b649aeaf32f1afa1e8490f2022-12-21T23:27:10ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2017-06-01116TC05TC0810.7860/JCDR/2017/24982.9984Role of Multivoxel Intermediate TE 2D CSI MR Spectroscopy and 2D Echoplanar Diffusion Imaging in Grading of Primary Glial Brain TumoursAbhishek Aggarwal0Pankaj Kumar Das1Arvind Shukla2Sagar Parashar3Mohini Choudhary4Arpit Kumar5Narendra Kumar6Shyamoli Dutta7Associate Professor, Department of Radiology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.Resident, Department of Radiology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.Professor, Department of Radiology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.Resident, Department of Radiology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.Resident, Department of Radiology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.Consultant, Department of Neurosurgery, Kumar Nursing Home, Moradabad, Uttar Pradesh, India.Consultant, Department of Neurosurgery, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.Professor, Department of Pathology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.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.https://jcdr.net/articles/PDF/9984/24982_CE[Ra]_F(Sh)_PF1(SY_SS)_PFA(SY_SS).pdfapparent diffusion coefficientbrain tumourdiffusion weighted imagingglioma gradingmagnetic resonance spectrosocopy
spellingShingle Abhishek Aggarwal
Pankaj Kumar Das
Arvind Shukla
Sagar Parashar
Mohini Choudhary
Arpit Kumar
Narendra Kumar
Shyamoli Dutta
Role of Multivoxel Intermediate TE 2D CSI MR Spectroscopy and 2D Echoplanar Diffusion Imaging in Grading of Primary Glial Brain Tumours
Journal of Clinical and Diagnostic Research
apparent diffusion coefficient
brain tumour
diffusion weighted imaging
glioma grading
magnetic resonance spectrosocopy
title Role of Multivoxel Intermediate TE 2D CSI MR Spectroscopy and 2D Echoplanar Diffusion Imaging in Grading of Primary Glial Brain Tumours
title_full Role of Multivoxel Intermediate TE 2D CSI MR Spectroscopy and 2D Echoplanar Diffusion Imaging in Grading of Primary Glial Brain Tumours
title_fullStr Role of Multivoxel Intermediate TE 2D CSI MR Spectroscopy and 2D Echoplanar Diffusion Imaging in Grading of Primary Glial Brain Tumours
title_full_unstemmed Role of Multivoxel Intermediate TE 2D CSI MR Spectroscopy and 2D Echoplanar Diffusion Imaging in Grading of Primary Glial Brain Tumours
title_short Role of Multivoxel Intermediate TE 2D CSI MR Spectroscopy and 2D Echoplanar Diffusion Imaging in Grading of Primary Glial Brain Tumours
title_sort role of multivoxel intermediate te 2d csi mr spectroscopy and 2d echoplanar diffusion imaging in grading of primary glial brain tumours
topic apparent diffusion coefficient
brain tumour
diffusion weighted imaging
glioma grading
magnetic resonance spectrosocopy
url https://jcdr.net/articles/PDF/9984/24982_CE[Ra]_F(Sh)_PF1(SY_SS)_PFA(SY_SS).pdf
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