DIAGNOSTIC ACCURACY OF MAGNETIC RESONANCE SPECTROSCOPY AND DIFFUSION WEIGHTED IMAGING IN GRADING OF INTRACRANIAL GLIOMAS TAKING HISTOPATHOLOGY AS GOLD STANDARD

Abstract

Objectives: To find diagnostic accuracy of magnetic resonance spectroscopy and magnetic resonance diffusion in grading of gliomas with histopathology as gold standard.

Methods: It is a Cross Sectional Study conducted at Department of Radiology, Mayo Hospital, Lahore. Duration was 06 months i.e Sep, 2018 to Mar, 2019. One hundred patients fulfilling selection criteria were enrolled in the study. Then all patients underwent MRI including conventional sequences as well as DWI and MRS using a spin echo sequence (SE) with short TE (35 mm/s) and long TE (144 mm/s). Patients were labeled as positive or negative (as per operational definition). Subsequently patients underwent biopsy under general anesthesia. Reports were assessed and patients were confirmed as positive or negative according to operational definition. All of this information was recorded in a predesigned Performa.

Results: Total number of patients in the study were one hundred. Mean age of the patients were 38.61(years) +11.40 whereas there were 43 (43.0) male and 57 (57.0) female patients included in the study. The diagnostic accuracy, sensitivity, specificity, PPV and NPV of magnetic resonance spectroscopy was 84.00%, 89.86%, 70.97%, 87.32% and 75.86% respectively whereas diagnostic accuracy, sensitivity, specificity, PPV and NPV of diffusion weighted imaging was 75.00%, 78.26%, 67.74%, 84.38% and 58.33% respectively.

Conclusion: The study concluded that diagnostic accuracy of MRS is more helpful and reliable than DWI in grading of gliomas taking histopathology as gold standard. Future studies at multiple setups must be conducted which could help in deciding whether to rely on MRS or DWI for determination of gliomas grading.