Grading of Glioma Tumors by Analysis of Minimum Apparent Diffusion Coefficient and Maximum Relative Cerebral Blood Volume

Gliomas are the most common primary neoplasms of the central nervous system. Relative cerebral blood volume (rCBV) could estimate high-grade Gliomas computed with dynamic susceptibility contrast MR imaging which it is artificially lowered by contrast extravasation through a disrupted blood-brain barrier.
Our intent was to clarify the usefulness of diffusion-weighted magnetic resonance imaging (DWI) and perfusion weighted magnetic resonance imaging (PWI) in the grading of Gliomas.
Both PWI and DWI with a three-tesla scanner investigated nineteen consecutive patients with Gliomas. The means of rCBV and ADC values have been compared among the tumor groups with t-test and ROC curve analysis to determine threshold values of Gliomas grading.
Mean maximum rCBV were 2.71±1.41 for low grades (I & II), and 8.14±2.58 for high grades (III & IV) Gliomas (p=0.001). Mean minimum ADC were 1.47±.46 ×103 mm2/s for low grades (I & II), and .47±.38×103 mm2/s for high grades (III & IV) Gliomas (p=0.001). We can get 0.94×103 mm2/s for minimum ADC and 3.85 for maximum rCBV as a difference cutoff point between low and high-grade Gliomas.
Combination of both DWI and PWI techniques, with measurement of minimum ADC and maximum rCBV can be used to distinguish between high grade and low-grade Glioma tumors.