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AJNR - American Journal of Neuroradiology

Published ahead of print on August 21, 2008
doi: 10.3174/ajnr.A1254

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Preoperative Grading of Presumptive Low-Grade Astrocytomas on MR Imaging: Diagnostic Value of Minimum Apparent Diffusion Coefficient

E.J. Lee^a,c, S.K. Lee^a,b, R. Agid^a, J.M. Bae^d, A. Keller^a and K. terBrugge^a

^a Department of Medical Imaging, Toronto Western Hospital, Toronto, Ontario, Canada
^b Department of Radiology, Lahey Clinic Medical Center, Burlington, Mass
^c Department of Radiology, Myong Ji Hospital, Kwandong University, Goyan-shi, South Korea
^d Department of Preventive Medicine, Jeju National Univeristy, Jeju, South Korea

View larger version (12K): [in this window] [in a new window]   Fig 1. Relationship between minimum ADC and grading of astrocytic tumors. Minimum ADC values (10–3 mm2 · sec–1) of low-grade astrocytomas are higher that those of high-grade astrocytomas, though some overlap is noted (P = .021).

View larger version (125K): [in this window] [in a new window]   Fig 2. A 44-year-old man with an anaplastic astrocytoma. A, Contrast-enhanced T1-weighted image shows a nonenhancing mass in the right frontal lobe. B, The mass shows increased signal intensity in the T2-weighted image with a focal hypointense area (arrows). C, On the DWI, the mass has relatively homogeneous increased signal intensity. D, The ADC map shows increased ADC with a region of interest placed in the focal area of low ADC within the mass. The lesion area has a minimum ADC of 0.902 x 10–3 mm2 · sec–1.

View larger version (124K): [in this window] [in a new window]   Fig 3. A 44-year-old man with a grade II diffuse astrocytoma. A, The contrast-enhanced T1-weighted image shows a nonenhancing mass in the left parietal lobe. B, The mass has relatively homogeneous increased signal intensity in the T2-weighted image. C, The DWI shows increased signal intensities compared with the surrounding regions. D, The ADC map shows high a ADC value compared with surrounding brain parenchyma with a subtle low ADC area with a region of interest placed for the lowest ADC measurement. The measured minimum ADC within the mass is 1.185 x 10–3 mm2 · sec–1.