Differentiation Between Low and High Grade in Non-Enhancing Cerebral Gliomas and Neuronal- Glial Tumors

Xiang Liu¹, Wei Tian¹, Sven Ekholm¹

Grading of non-enhancing supratentorial gliomas and neuronal-glial tumors (NEGNGT) is a diagnostic dilemma on conventional MR imaging as 45% of these tumors could be malignant. We retrospectively compared diffusion tensor imaging (DTI), MR perfusion weighted imaging (PWI) and MR spectroscopic imaging in preoperative grading of 50 patients with histology confirmed non-enhancing supratentorial gliomas and neuronal-glial tumors. The imaging parameters, included mean FA, mean FA ratio, maximal FA, minimal ADC, maximal rCBV, Cho/Cr and Cho/NAA which all were evaluated for both tumor groups. There were significant differences of mean FA, mean FA ratio and maximal FA between low and high grade NEGNGT(p<0.05), but no significance was found for the other parameters. ROC analysis showed that the maximal FA value had a higher sensitivity and specificity than the other parameters to differentiate between low and high grade NEGNGT. This result indicates that maximal FA may be the best adjuvant tool to help differentiating between low and high grade in non-enhancing supratentorial gliomas and neuronal-glial tumors.