Diagnostic Value of Apparent Diffusion Coefficient Statistics in Differentiating the Glioblastoma Tumors with an Oligodendroglioma and Glioblastomas Without Such Moiety

Background: Differentiating types of brain tumors using magnetic resonance imaging (MRI) as a non-invasive element is essential. Objectives: The study aimed at evaluating the difference in the first-order histogram (FOH) features obtained from apparent diffusion coefficients (ADCs) between glioblastoma (GBM) tumors with or without oligodendroglial (ODG) components. Methods: MRIs were taken before surgical resection of the brain tumors. The brain lesions were analyzed and ADC maps were plotted to calculate FOH. Brain lesions were surgically removed, diagnosed using pathological methods, and categorized as GBM with an ODG (GBM-ODG) or without ODG. A comparison of ADC values was performed between GBM-ODG and GBM. Receiver-operator characteristic (ROC) curves were used to determine the cut-off sensitivity and specificity values. Results: In the GBM group, 26 patients were included; 20 cases were male and 6 were female; the mean ± SD of age was 54.1 ± 1.2 and 55.2 ± 1.6 years, respectively. In the GBM-ODG group, 31 patients were included; 22 cases were male and 9 cases were female; the mean ± SD of 52.1 ± 0.8 and 55.3 ± 1.5 years, respectively. The results of peritumoral edema had several significant FOHs. In the MRIs of tumor and T1W groups, the third moment and minimum-ADC had significant results, respectively. Cut-off values of the FOHs were statistically significant outcomes in the peritumoral edema region when compared between GBM-ODG and GBM categories: Median > 1.3516, normal mean > 0.6671, third moment ≤ -0.0001, 25 percentile > 0.5929, 75 percentile > 0.7336, and 95 percentile > 0.8542. The highest sensitivity and specificity values for these FOHs were higher than 80% and sometimes near 99.9%. Conclusions: The results showed that ADC values from peritumoral edema regions differ between these two types of tumors. Then, an MRI from the edematous areas is suggested when evaluating the patient's status and deciding to make interventions.