The added value of the apparent diffusion coefficient calculation to magnetic resonance imaging in the differentiation and grading of malignant brain tumors

J Comput Assist Tomogr. Nov-Dec 2004;28(6):735-46. doi: 10.1097/00004728-200411000-00003.

Abstract

Objective: ADC calculation can improve the diagnostic efficacy of MR imaging in brain tumor grading and differentiation.

Methods: Apparent diffusion coefficient (ADC) values and ratios of 33 low-grade (23 astrocytomas, 10 oligodendrogliomas) and 40 high-grade (25 metastases and 15 high-grade astrocytomas) malignant tumors were prospectively evaluated.

Results: Tumoral ADC values (r=-0.738, P <0.000) and ratios (r=-0.746, P < 0.000) were well correlated with higher degree of malignancy and quite effective in grading of malignant brain tumors (P < 0.000). By using cutoff values of 0.99 for tumoral ADC value and 1.22 for normalized ADC ratio, the sensitivity of MR imaging could be increased from 72.22% to 93.75% and 90.63%, the specificity from 81.08% to 92.68% and 90.24%, PPV from 78.79% to 90.91% and 87.88%, and NPV from 75.00% to 95.00% and 92.50%, respectively.

Conclusion: ADC calculation was quite effective in grading of malignant brain tumors but not in differentiation of them and added more information to conventional contrast-enhanced MR imaging.

MeSH terms

  • Adolescent
  • Adult
  • Astrocytoma / diagnosis
  • Astrocytoma / pathology
  • Brain / pathology
  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / pathology
  • Brain Neoplasms / secondary
  • Contrast Media
  • Diffusion Magnetic Resonance Imaging / methods*
  • Female
  • Glioblastoma / diagnosis
  • Glioblastoma / pathology
  • Humans
  • Image Enhancement / methods*
  • Male
  • Middle Aged
  • Oligodendroglioma / diagnosis
  • Oligodendroglioma / pathology
  • Predictive Value of Tests
  • Prospective Studies
  • ROC Curve
  • Sensitivity and Specificity
  • Single-Blind Method

Substances

  • Contrast Media