Vojnosanitetski pregled 2015 Volume 72, Issue 10, Pages: 870-875
https://doi.org/10.2298/VSP140229073I
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Apparent diffusion coefficient in the evaluation of cerebral gliomas malignancy
Ignjatović Jelena (University of Niš, Faculty of Medicine, Niš, Serbia)
Stojanov Dragan (University of Niš, Faculty of Medicine, Niš, Serbia)
Živković Vladimir (Ministry of Defence, Belgrade, Serbia)
Ljubisavljević Srđan (University of Niš, Faculty of Medicine, Niš, Serbia)
Stojanović Nebojša (University of Niš, Faculty of Medicine, Niš, Serbia)
Stefanović Ivan (University of Niš, Faculty of Medicine, Niš, Serbia)
Benedeto-Stojanov Daniela (University of Niš, Faculty of Medicine, Niš, Serbia)
Ignjatović Nebojša (University of Niš, Faculty of Medicine, Niš, Serbia)
Petrović Slađana (University of Niš, Faculty of Medicine, Niš, Serbia)
Aracki-Trenkić Aleksandra (Clinical Center of Niš, Center of Radiology, Niš, Serbia)
Radovanović Zoran (University of Niš, Faculty of Medicine, Niš, Serbia)
Lazović Lazar (Clinical Center of Niš, Center of Radiology, Niš, Serbia)
Background/Aim. Magnetic resonance imaging (MRI) is a key modality not only
for lesion diagnosis, but also to evaluate the extension, type and grade of
the tumor. Advanced MRI techniques provide physiologic information that
complements the anatomic information available from conventional MRI. The
aim of this study was to determine whether there is a correlation between
apparent diffusion coefficient (ADC) maps of intracranial glial tumors and
histopathologic findings and whether ADCs can reliably distinguish lowgrade
from high-grade gliomas. Methods. This retrospective study included 25
patients with MRI examination up to seven days before surgery, according to
the standard protocol with the following sequences: T1WI, T2WI, FLAIR, DWI
and post contrast T1WI. Data obtained from DW MRI were presented by
measuring the value of ADC. The ADC map was determined by utilizing
Diffusion-Perfusion (DP) Tools software. All the patients underwent surgical
resection of the tumor. Histological diagnosis of tumors was determined
according to the World Health Organization (WHO) classification. The ADC
values were compared with the histopathologic findings according to the WHO
criteria. Results. The ADC values of astrocytomas grades I (0.000614 ±
0.000032 mm2/s) were significantly higher (< 0.001) than the ADC values of
anaplastic astrocytomas (0.000436 ± 0.000016 mm2/s) and the ADC values of
glioblastomas multiforme (0.000070 ± 0.000008 mm2/s). The ADC values of
astrocytomas grades II (0.000530 ± 0.000114 mm2/s) were significantly higher
(< 0.001) than the ADC values of anaplastic astrocytomas (0.000436 ±
0.000016 mm2/s) and glioblastomas multiforme (0.000070 ± 0.000008 mm2/s).
The ADC values of anaplastic astrocytomas (0.000436 ± 0.000016 mm2/s) were
significantly higher (< 0.001) than the ADC values of glioblastomas
multiforme (0.000070 ± 0.000008 mm2/s). The ADC values in the cystic part of
the tumor for astrocytomas grades I (0.000775 ± 0.000023 mm2/s) were
significantly higher (< 0.001) than the ADC values of anaplastic
astrocytomas (0.000119 ± 0.000246 mm2/s) and glioblastomas multiforme
(0.000076 ± 0.000004 mm2/s). The ADC values astrocytomas grades II (0.000511
± 0.000421 mm2/s) were significantly higher (< 0.001) than the ADC values of
glioblastomas multiforme (0.000076 ± 0.000004 mm2/s). Concluson. DWI with
calculation of ADC maps can be regarded as a reliable useful diagnostic
tool, which indirectly reflects the proliferation and malignancy of gliomas.
The ADCs maps can both predict the results of histopathological tumor and
distinguish between low- and high-grade gliomas, and provide significant
information for presurgical planning, treatment and prognosis for patients
with highgrade astrocytomas.
Keywords: glioma, diffusion magnetic resonance imaging, diagnosis, neoplasm staging