The correlation histopathological and conventional/advanced MRI techniques in glial tumors

Objective: We aimed to elucidate the histopathological pre-diagnosis of cranial gliomas with magnetic resonance imaging (MRI) techniques in gliomas. Method: A total of 82 glioma patients were enrolled to our study. Pre-operative conventional MRI images (non-contrast T1/T2/flair/contrast-enhanced T1) and advanced MRI images (DAG and ADC mapping, MRI spectroscopy and perfusion MRI [PMRI]) were analyzed. Results: Conventional MRI alone is useful in radiological pre-evaluation in low-grade glioma in 54.8% and 86.3% in high-grade glioma. Additional advanced MRI techniques were beneficial in comparing low-grade gliomas in 98% and 83.9% in high-grade glioma. On ROC analysis, ADC cutoff value 0.905 mm²/s (p = 0.001), rCBV cutoff value 1.77 (p = 0.001), Cho/NAA cut-off value 2.20 (p = 0.001), and Cho/Cr cutoff value 2.01 (p = 0.001) were achieved. Significant results were obtained when ADC, Cho/NAA, and Cho/Cr were analyzed into four histopathologically grade groups besides (p = 0.001). NAA/Cr values were not significant in pathological grading. rCBV measurements were statistically significant between Grades I and IV and between II and IV. Conclusion: Using additional advanced MRI techniques such as PMRI, magnetic resonance spectroscopy, and DWI with conventional MRI could enhance the accuracy of histopathological grading in cranial glioma.