Diagnostic accuracy of magnetic resonance imaging in detection of intra-axial gliomas

Abstract

Objective: To evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) in detection of intra-axial gliomas in suspected cases keeping histopathology as gold standard.
 Methods: This cross-sectional study was conducted at Dow Institute of Radiology, DUHS from October 2017 - April 2018. Patients of either gender aged 30-70 years presenting with headache were included. Patients already diagnosed and referred for follow up were excluded. MRI was performed on 1.5T scanner by a trained MRI technician. T1, T2, FLAIR, diffusion weighted and T1 post contrast images were acquired and reviewed by two radiologists having more than five years post fellowship experience. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of MRI for intraaxial gliomas was calculated taking histopathology findings as gold standard.
 Results: Mean age of the patient`s was 51.71 ±10.85 years. Positive intraaxial gliomas on MRI were observed in 123 (79.90%) patients while on histopathology, positive intraaxial gliomas were observed in 131 (85.10%) patients. Diagnostic accuracy of MRI in detection of intra-axial gliomas taking histopathology findings as gold standard showed sensitivity, specificity, positive predicted value (PPV), negative predicted value (NPV) and overall diagnostic accuracy as 89.31%, 73.91%, 95.12%, 54.84% and 87.01%.
 Conclusions: MRI has high sensitivity, moderate specificity and high diagnostic accuracy in detection of intraaxial gliomas.
 doi: https://doi.org/10.12669/pjms.37.1.2489
 How to cite this:Munir S, Khan SA, Hanif H, Khan M. Diagnostic accuracy of magnetic resonance imaging in detection of intra-axial gliomas. Pak J Med Sci. 2021;37(1):125-130. doi: https://doi.org/10.12669/pjms.37.1.2489
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Role of Magnetic Resonance Imaging (MRI) in grading gliomas comparable with pathology: A cross-sectional study from Syria

“…All gliomas were hyperintense in T2 and in FLAIR, while 92% of them were hypointense in T1. High-grade tumors were heterogeneous contrast enhancement with other medical imaging aspects of MRI such as bleeding, necrosis, and edema [ 7 , 11 ]. Glioblastoma multiforme represented 61.5% of the supratentorial gliomas in our study and is similar to their proportion in the Zena Study., Et al (2014) 56,25% [ 12 ], but it was less than 39% in the study of Al-Najjar., Et al (2003) [ 13 ], and this can be explained by the difference in the target age group where patients younger than 40 years was used in the study of Al-Najjar where the pilocytic astrocytoma is more common than GBM.…”

Diagnostic Accuracy of Magnetic Resonance Spectroscopy in Predicting the Grade of Glioma Keeping Histopathology as the Gold Standard

“…The prognosis of patients with brain tumors improves if the tumor is discovered early [1]. Gliomas are one of the most common types of brain tumors, with a five-year survival rate of less than 5%.…”

“…Severe problems are associated with stereotactic brain biopsies needing definitive histology in determining the grade of malignancy, including seizures, temporary or permanent neurological damage, and intracranial bleeding [3]. A sample error, which can lead to a faulty diagnosis, is also a possibility [1]. Hence, neuroimaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), can be used to detect and grade brain tumors [4].…”

“…Hence, neuroimaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), can be used to detect and grade brain tumors [4]. Lesion aggressiveness is indicated by MRI findings such as postcontrast enhancement, necrosis inside the tumor, and substantial perilesional edema or mass impact [1]. It is possible to use these characteristics to determine the grade of gliomas [1].…”

“…Lesion aggressiveness is indicated by MRI findings such as postcontrast enhancement, necrosis inside the tumor, and substantial perilesional edema or mass impact [1]. It is possible to use these characteristics to determine the grade of gliomas [1]. Biochemical indicators in the brain can be measured by magnetic resonance spectroscopy (MRS), which can be used in conjunction with standard MRI to predict the grade of the identified lesions.…”