以组织病理学为金标准的表观扩散系数(ADC)在鉴别低级别和高级别胶质瘤中的诊断准确性

Selehria Atiq-ur-Rehman, Aquil Hafsa, Sheraz Atif, K. Sara, Z. Najwa, Kayani Anashia
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摘要

胶质瘤是最严重的中枢神经系统恶性肿瘤之一,死亡率高,生存率低,严重致残,复发风险高。他的研究目的是以组织病理学为金标准,确定表观扩散系数(ADC)在鉴别低级别和高级别胶质瘤中的诊断准确性。这是一项横断面验证研究,于2022年2月28日至2022年8月27日在巴基斯坦拉瓦尔品第的武装部队放射学和成像研究所(AFIRI)进行。材料和方法:215例局灶性脑病变患者,年龄25-65岁,男女不限。排除装有心脏起搏器、哺乳期女性、去髓鞘病变和恶性浸润、肾功能衰竭的患者。然后采用1.5 Tesla MR系统对患者进行弥散加权磁共振成像。确定实体肿瘤成分内最大扩散限制区域(最低ADC),同时避免肿瘤周围水肿区域。ADC的结果由放射科顾问医师(至少5年的研究后经验)解释高级别或低级别胶质瘤。在此之后,每位患者在相关病房进行活检,并将组织病理学结果与ADC结果进行比较。结果:以组织病理学为金标准,表观扩散系数(ADC)鉴别低级别和高级别胶质瘤的总体敏感性、特异性、阳性预测值、阴性预测值和诊断准确率分别为93.65%、87.64%、91.47%、90.70%和91.16%。结论:表观扩散系数(ADC)是鉴别低级别和高级别胶质瘤的非侵入性诊断方法。
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Diagnostic accuracy of apparent diffusion coefficient (ADC) in differentiating low- and high-grade gliomas, taking histopathology as the gold standard
Gliomas are known to be one of the most grievous malignant central nervous system (CNS) tumors and have a high mortality rate with a low survival rate severe disability and increase risk of recurrence. Aim of his study is to determine the diagnostic accuracy of apparent diffusion coefficient (ADC) in differentiating low-grade and high-grade gliomas, taking histopathology as the gold standard. It is a Cross-sectional validation study conducted at the Armed Forces Institute of Radiology and Imaging, (AFIRI) Rawalpindi, Pakistan from 28th February 2022 to 27th August 2022. Materials and methods: A total of 215 patients with focal brain lesions of age 25-65 years of either gender were included. Patients with a cardiac pacemaker, breastfeeding females, de-myelinating lesions and malignant infiltrates, and renal failure were excluded. Then diffusion-weighted magnetic resonance imaging was performed on each patient by using a 1.5 Tesla MR system. The area of greatest diffusion restriction (lowest ADC) within the solid tumor component was identified while avoiding areas of peritumoral edema. Results of ADC were interpreted by a consultant radiologist (at least 5 years of post-fellowship experience) for high or low-grade glioma. After this, each patient has undergone a biopsy in the concerned ward, and histopathology results were compared with ADC findings. Results: Overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of apparent diffusion coefficient (ADC) in differentiating low- and high-grade gliomas, taking histopathology as the gold standard was 93.65%, 87.64%, 91.47%, 90.70% and 91.16% respectively. Conclusion: This study concluded that apparent diffusion coefficient (ADC) is the non-invasive modality of choice with high diagnostic accuracy in differentiating low- and high-grade gliomas.
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