Differentiation between high-grade gliomas and metastatic brain tumors using Diffusion Tensor Imaging metrics

Abstract

Introduction The aim of this work was to differentiate between high-grade gliomas and metastatic brain tumors using diffusion tensor derived metrics in the enhancing tumor and peri-tumoral regions. Patients & methods Prospective study was done on 36 patients with provisional MRI diagnosis of high grade gliomas WHO grade III & IV versus metastatic brain tumors, examination was done on 1.5 tesla scanner, patients were divided into two groups based on pathology results, the fraction anisotropy (FA), mean diffusivity (MD), linear coefficient (CL), planer coefficient (CP) and spherical coefficient (CS) were measured in the enhancing tumor parts and immediate peri-tumoral edema and results were compared between the two groups. Results Values of FA, CL and CP measured in the peri-tumoral edema were significantly high in the metastatic than primary high malignant glial tumors with high specificity (100%) of the CP and high sensitivity of the CL (76.5%) among the three significant values, and no significant differences in the values of MD and CS. The values of the five metrics measured in the enhancing tumor parts showed no significant differences between the two groups. Conclusion Brain metastasis and high-grade gliomas can be differentiated using DTI derived FA, CL and CP measured in the peri-tumoral region.