Usefulness of diffusion/perfusion-weighted MRI in patients with non-enhancing supratentorial brain gliomas: a valuable tool to predict tumour grading?

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Abstract
22 patients with non-enhancing supratentorial gliomas on contrast-enhanced MRI underwent both diffusion- and perfusion-weighted MRI (DWI/PWI) before surgical resection. 14 low-grade gliomas (WHO Grade I and II) and 8 anaplastic gliomas were verified histologically. Both apparent diffusion coefficient (ADC) values and relative cerebral blood volume (rCBV) ratios were calculated on the solid portion of the tumour, on peritumoural area, as well as on the contralateral normal white matter, respectively. The results showed that lower ADC values were present in the solid portions of anaplastic gliomas, but not in low grade (pp<0.01). In conclusion, non-enhancing brain gliomas with lower ADC values in the solid portions and higher rCBV ratios in both solid portions and peritumoural regions of tumours are significantly correlated with anaplasia. Therefore, DWI and PWI should be integrated in the diagnostic work-up of non-enhancing gliomas in order to predict grading.