Comparison between ultra-high and conventional mono b-value DWI for preoperative glioma grading

// Yu-Chuan Hu 1, * , Lin-Feng Yan 1, * , Qian Sun 1 , Zhi-Cheng Liu 1 , Shu-Mei Wang 2 , Yu Han 1 , Qiang Tian 1 , Ying-Zhi Sun 1 , Dan-Dan Zheng 3 , Wen Wang 1 and Guang-Bin Cui 1 1 Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi’an, China 2 Department of Pathology, Tangdu Hospital, Fourth Military Medical University, Xi’an, China 3 MR Research China, GE Healthcare China, Beijing, China * These authors have contributed equally to this work Correspondence to: Guang-Bin Cui, email: cgbtd@126.com Wen Wang, email: wangwen@fmmu.edu.cn Keywords: glioma, grading, diffusion-weighted imaging, MRI, apparent diffusion coefficient Received: August 17, 2016     Accepted: November 22, 2016     Published: December 26, 2016 ABSTRACT To compare the efficacy of ultra-high and conventional mono-b-value DWI for glioma grading, in 109 pathologically confirmed glioma patients, ultra-high apparent diffusion coefficient (ADC uh )was calculated using a tri-exponential mode, distributed diffusion coefficients (DDCs) and α values were calculated using a stretched-exponential model, and conventional ADC values were calculated using a mono-exponential model. The efficacy and reliability of parameters for grading gliomas were investigated using receiver operating characteristic (ROC) curve and intra-class correlation (ICC) analyses, respectively. The ADC uh values differed (P < 0.001) between low-grade gliomas (LGGs; 0.436 ×10 −3 mm 2 /sec) and high-grade gliomas (HGGs; 0.285 × 10 −3 mm 2 /sec). DDC, a and various conventional ADC values were smaller in HGGs (all P ≤ 0.001, vs. LGGs). The ADC uh parameter achieved the highest diagnostic efficacy with an area under curve (AUC) of 0.993, 92.9% sensitivity and 98.8% specificity for glioma grading at a cutoff value of 0.362×10 −3 mm 2 /sec. ADC uh measurement appears to be an easy-to-perform technique with good reproducibility (ICC = 0.9391, P < 0.001). The ADC uh value based in a tri-exponential model exhibited greater efficacy and reliability than other DWI parameters, making it a promising technique for glioma grading.