Apparent diffusion coefficient values with normalization in Correspondence with who grading of glial tumours of the brain

Aim: To evaluate the Apparent diffusion co-efficient in grading of Glial tumors with histo-pathological gradingMethod: Cross sectional hospital based observational study conducted over a time period of 2 years. All the cases registered with Acharya Vinoba Bhave Rural Hospital Sawangi, Wardha, diagnosed on histo-pathological findings as Glial tumours were included in this present study. All patients were examined on GE Brivo MRI machine with 1.5 Tesla 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 the 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. The mean ADC for Pleomorphic xanthoastrocytoma, pontine glioma, thalamic glioma and Low grade gliomas were 0.98, 0.82, 0.95 and 0.89 respectively. While, the mean normalized ADC for Pleomorphic xanthoastrocytoma, pontine glioma, thalamic glioma and Low grade gliomas were 1.23, 1.03, 1.19 and 1.12 respectively.Conclusion: The research gap analysis towards which research question was framed stands filled up by the generated new knowledge in terms of ‘Apparent Diffusion Coefficient’ and ‘Normalised Apparent Diffusion Coefficient’ values with identified cut off / demarcating values for gradation of Glial Tumors into Low Grade / High Grade tumors