Comparison of Pathological Indexes (Ki-67, p53), and Perfusion/Diffusion MR Parameters in Glioma Staging

Abstract

Aim: In this study, we aim to determine the diffusion characteristics of grade II astrocytomas and glioblastomas (GBM), and to determine the ability of apparent diffusion coefficient (ADC), relative cerebral blood volume (rCBV), Ki-67, and p53 values for the preoperative stratification of these tumors.Material and Methods: MRI scans of 24 patients who underwent surgery for brain tumors in our hospital between 2014 and 2017 with grade II diffuse astrocytoma or GBM were retrospectively reviewed. The ADC and rCBV values were measured from inside the tumor and from the normal white matter of symmetric contralateral hemisphere. Ki-67 and p53 values were recorded from the pathology reports. Perfusion weighted imaging, diffusion weighted imaging, Ki-67, and p53 values were analyzed for differences between low-grade and high-grade astrocytomas.Results: In grade II astrocytomas, the ADC values significantly increased compared to contralateral normal hemisphere, while in GBMs they were slightly increased. The success of rCBV using a value of 2 in distinguishing high- and low-grade astrocytomas was statistically significant and 100% accurate. As the min ADC value declined in GBMs the p53 score increased. Similarly, the p53 score increased as the min ADC and the average ADC values of GBM in the contralateral normal white matter (WM) declined.Conclusion: Utilizing an rCBV value of 2 to distinguish grade II from grade IV astrocytomas is superior to relying on ADC values to predict grade. The decline in the ADC values of GBM in the normal WM of contralateral hemisphere corroborates the notion of a diffuse neoplastic process.