Estimation of the Mean Metabolic Ratio for The Purpose of Grading of Glial Tumours of The Brain

Aim – To evaluate the metabolic ratios for grading of Glial tumors with histo-pathological grading.Method: Cross sectional hospital based observational study conducted over time period of 2 years. All cases registered with Acharya Vinoba Bhave Rural Hospital Sawangi, Wardha, diagnosed on histo-pathological findings as Glial tumours were included in present study. All patients were examined on GE Brivo MRI machine with 1.5Tesla magnetic field strength in the Department of Radiodiagnosis. Using b value of 1000 s/sq. mm, slice thickness 5mm, interslice gap 2mm applied in the x, y and z axes, central as well as peripheral portions of the tumor were manually sampled, preferably getting rid of any cystic or necrotic areas within them. Histo-pathological diagnostic acumen was augmented with radiological features of brain tumors upon routine MRI SEQUENCES coupled with ADC values.Result: In the present study, out of the total of 142 patients included, the glial tumour cases were 54 in number. Amongst this group of glial tumours, the tumours diagnosed were pleomorphic xanthoastrocytoma, pontine glioma, and thalamic glioma, low grade glioma at other sites, high grade gliomas, grade 3 astrocytomas, glioblastoma multiformae, gliomatosis cerebri and gliosarcoma. Upon application of logistic regression analysis, ‘cut off values’ for different metabolite ratios were calculated towards facilitation of grading of brain tumours. The observed ‘cut off values’ were 0.96 for Mi:Cr, 1.03 for Naa:Cr, Cho:LL showed it to be 1.452, 2.15 for Cho:Cr, 2.06 for Cho:Naa, 2.04 for LL:Cr and 2.48 for Cho:Mi respectively.Conclusion: The research gap analysis towards which research question was framed stands filled up by the generated new knowledge in terms of ‘’metabolic ratios’ with identified cut off / demarcating values for gradation of Glial Tumors into Low Grade / High Grade tumors