Diagnostic Accuracy of Apparent Diffusion Coefficient Value in Differentiating Benign and Malignant Brain Lesions Keeping Histopathology as Gold Standard

Abstract

Objective: The purpose of this study was to assess the competence of preoperative Apparent Diffusion Coefficient (ADC) values in predicting brain tumors as benign or malignant, keeping histopathology as the gold standard.
Study Design: Cross-sectional study.
Place and Duration of Study: The study was carried out at the Department of Diagnostic Radiology, POF Hospital, Wah Cantt, Pakistan, from December 12^th 2020 to June 9^th 2021.
Materials and Methods: The apparent diffusion coefficient (ADC) sequence is based on the diffusion properties of water molecules within tissues and correlates with tissue cellularity. ADC may have a role in predicting tumor grade for gliomas and may in turn, assist in identifying tumor biopsy sites.
A total of 140 patients were enrolled in the study. In all the images, the slice thickness was taken as 3mm, and the slice gap of 10. The mean age of the patients was 46.5±14.0 years. Males were predominant. The mean BMI was 26.8±5.5 kg/m2, and the mean duration of symptoms was 2.0±1.4 months.
Results: The mean age of the patients enrolled in the study was 46.5±14.0 years. Males were predominant; there were 85 males (60.7%) and 55 females (39.3%). The mean duration of symptoms was 2.0±1.4 months. A history of chronic headache was found in 100 patients (71.4%), a history of seizures in 20 (14.3%), and a history of focal deficit was present in 111 patients (79.3%). Apparent diffusion coefficient (ADC) value in differentiating benign and malignant brain lesions showed sensitivity 77.5%, specificity 91.6%, PPV 92.5%, NPV 75.3% and diagnostic accuracy 83.5%.
Conclusion: Overall, malignant brain lesions display lower ADC values than benign ones. Apparent diffusion coefficient (ADC) values improved our abilities to differentiate benign from malignant brain lesions.