Sing, Tan Kia
(2016)
Grading of supratentorial gliomas using MR diffusion tensor imaging.
Masters thesis, Pusat Pengajian Sains Perubatan.
Abstract
Background and Purpose: Gliomas, being the most common primary brain
tumours are usually located at the supratentorial regions in adults. They are
classified into low grade (grade I and II) and high grade (grade III and IV)
based on WHO classification. Conventional MR imaging is essential to
characterise the tumour morphology but lack accuracy in determining the
grade of tumours. Advanced MRI technique such as DTI has emerged over
the past decades as an additional method to further evaluate the brain
tumours at the microstructural and physiological levels.
Accurate grading of gliomas is important to determine the mode of treatment
and sequences of management for patients. Therefore, this study aims at
retrospectively determines whether FA or ADC values at 3-Tesla MR DTI are
significantly different between low grade and high grade supratentorial
gliomas. FA and ADC values between the gliomas and normal cerebral
hemisphere are also being compared.
Methodology: Sixteen patients aged 18 years old and above with newly
diagnosed supratentorial gliomas with histopathological results were included.
Their MRI with DTI sequence were retrieved from PACS into extended MR
workspace for data analysis. DTI data was co-registered with post-gadolinium
T1 weighted images. Four ROIs were drawn at the anterior, posterior, lateral
and medial margins of tumours. ROIs were also placed at the contralateral
NAWM of the opposite lobe. Comparison of FA and ADC values between low
grade and high grade gliomas, and between gliomas with contralateral NAWM
was performed using Mann-Whitney U test and Wilcoxon signed ranks test
respectively.
Results: There was significant difference between FA of low grade and high
gliomas, and between FA and ADC of gliomas and contralateral NAWM (p <
0.05). No statistical significant difference was found between the ADC of low
grade and high grade gliomas (p = 0.129).
Conclusion: FA values generated from DTI can be used to grade gliomas.
ADC values of low grade gliomas are higher than that of high grade gliomas
but are not statistical significantly different.
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