The benefits of diffusion mr and apparent diffusion coefficient (ADC) in differential diagnosis of brain tumors

Purpose: Examining the contribution of Diffusion-Weighted Imaging(DWI) and Apparent Diffusion Coefficient (ADC) to the differential diagnosis and staging of brain tumors. Material and Method: Contrasted brain MR and DWI were administered to the patients who were pre-diagnosed with intracranial bulk between June 2013-May 2015 by using the 1,5 tesla MR in our department. 115 patients whose ages varied between 20-82 and having contrasted solid components and who had peri-tumoral edema area and supratentorial intra-axial bulk were included in the study. In each case, minimum, average and maximum tumoral, peri-tumoral ADC values and ratios were measured in the contrasted solid component of the tumor, peri-tumoral edema area, and contralateral normal white matter by using the ROI to the relevant areas. The issue of whether there is a significant difference between the groups was analyzed with statistical methods. Findings: Of the 115 patients, 22 were diagnosed with low-level glioma, 55 with high-level glioma, 6 with cerebral lymphoma, and 22 with metastasis with biopsy. 10 patients were diagnosed with metastasis with follow-up. The tumoral ADC ratios were found as higher in low-level glial tumors than the ratios in other tumor groups (p<0,024). There was a significant difference only between the low-level and high-level glial tumors in terms of tumoral ADC values (p<0,012). In the tumoral ADC values and ratios, no significant differences were determined between the high-level glial tumors and metastasis and lymphoma (p>0,788). It was found to be lower in the ADC values and ratios that were measured in peri-tumoral edema areas and in high-level glial tumors when compared with the other tumor groups (p<0,036). No significant differences were determined between the low-level glial tumors and metastasis and lymphoma in peri-tumoral ADC values and ratios (p>0,679). No significant differences were detected between the metastasis and lymphoma in all ADC values and ratios (p>0,692). Conclusion: Using the ACD values measured in tumoral, peri-tumoral and edema areas together with the conventional MRG and DWI may be beneficial in distinguishing between the lymphoma, metastasis, low-level and high-level glial tumors.