title: Assessment of diffusion tensor imaging metrics in differentiating low-grade from high-grade gliomas.
abstract: OBJECTIVE
  The aim of this article is to assess diffusion tensor imaging (DTI) metrics in differentiating low-grade from high-grade gliomas.
  
  
  METHODS
  A prospective study was conducted on 35 patients with gliomas who underwent DTI. Gliomas were classified into low-grade and high-grade gliomas. The fractional anisotropy (FA), mean diffusivity (MD), linear coefficient (CL), planar coefficient (CP) and spherical coefficient (CS) of the solid tumoral part and peri-tumoral regions were calculated.
  
  
  RESULTS
  There was significant difference (p = 0.001) in MD of the solid tumoral part of low-grade (1.78 ± 0.33 × 10(-3 )mm(2)/s) and high-grade (1.16 ± 0.22 × 10(-3 )mm(2)/s) gliomas. The selection of 1.42 × 10(-3 )mm(2)/s as a cutoff value of MD of the tumoral part was used to differentiate low-grade and high-grade gliomas; the best results were obtained with area under the curve (AUC) of 0.957 and accuracy of 91.4%. There was a significant difference in FA, MD, CP and CS of peri-tumoral regions of both groups with p values of 0.006, 0.042, 0.030 and 0.037, respectively. The cutoff values of MD, FA, CS and CP of the peri-tumoral region used to differentiate low-grade from high-grade gliomas were 1.24, 0.315, 0.726 and 0.321 with AUC of 0.694, 0.773, 0.734 and 0.724 and accuracy of 68.6%, 80.0%, 74.3% and 74.3%, respectively. The combined MD of the solid tumoral part and FA of the peri-tumoral region used to differentiate low-grade from high-grade gliomas revealed AUC of 0.974 and accuracy of 88.6%.
  
  
  CONCLUSIONS
  We conclude that the combination of MD of the solid tumoral part and FA of the peri-tumoral region is a noninvasive method to differentiate low-grade from high-grade gliomas.
authors: Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Egypt.
authors: Lamiaa
authors: L
authors: El-Serougy
authors: Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Egypt arazek@mans.edu.eg.
authors: Ahmed Abdel Khalek
authors: AA
authors: Abdel Razek
authors: Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Egypt.
authors: Amani
authors: A
authors: Ezzat
authors: Department of Neurosurgery, Mansoura Faculty of Medicine, Egypt.
authors: Hany
authors: H
authors: Eldawoody
authors: Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Egypt.
authors: Ahmad
authors: A
authors: El-Morsy
mesh_terms: D000368:Aged; D016880:Anisotropy; D019540:Area Under Curve; D001932:Brain Neoplasms / Q000000981:diagnostic imaging*; D056324:Diffusion Tensor Imaging; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
keywords: Diffusion tensor imaging; glioma; grading