Diagnostic accuracy of magnetic resonance imaging in detection of intra-axial gliomas.

Sohbia Munir,Sohail Ahmed Khan,Maria Khan,Hina Hanif

doi:10.12669/pjms.37.1.2489

Abstract

Objective:To evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) in detection of intra-axial gliomas in suspected cases keeping histopathology as gold standard.Methods:This cross-sectional study was conducted at Dow Institute of Radiology, DUHS from October 2017 - April 2018. Patients of either gender aged 30-70 years presenting with headache were included. Patients already diagnosed and referred for follow up were excluded. MRI was performed on 1.5T scanner by a trained MRI technician. T1, T2, FLAIR, diffusion weighted and T1 post contrast images were acquired and reviewed by two radiologists having more than five years post fellowship experience. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of MRI for intraaxial gliomas was calculated taking histopathology findings as gold standard.Results:Mean age of the patient`s was 51.71 ±10.85 years. Positive intraaxial gliomas on MRI were observed in 123 (79.90%) patients while on histopathology, positive intraaxial gliomas were observed in 131 (85.10%) patients. Diagnostic accuracy of MRI in detection of intra-axial gliomas taking histopathology findings as gold standard showed sensitivity, specificity, positive predicted value (PPV), negative predicted value (NPV) and overall diagnostic accuracy as 89.31%, 73.91%, 95.12%, 54.84% and 87.01%.Conclusions:MRI has high sensitivity, moderate specificity and high diagnostic accuracy in detection of intraaxial gliomas.

Highlights

Gliomas are the most common intrinsic tumours of the central nervous system and are graded according to the World Health Organization (WHO), from Grade-I to Grade-IV, with increasing malignancy.[1,2,3] The incidence of brain tumors has increased in recent several years, and the incidence shows significant difference in terms of gender, age, race, ethnicity, and even geographical region.[4]Paediatric brainstem gliomas (BSG) account for 10-20% of CNS neoplasms in children.[5]
While those patients already diagnosed as having intra-axial gliomas and came for follow-up, pregnant women, patients allergic to intravenous contrast and abnormal renal function tests and all patients who were claustrophobic to magnetic resonance imaging (MRI) were excluded
This study was conducted in large tertiary care public sector in radiology institution.Sample size was calculated using prevalence of intraaxial glioma as 69%11, sensitivity of MRI: 93%11, specificity of MRI: 77%11 with margin of error 5% for sensitivity and 10% for specificity, Confidence level of 95%

Summary

Introduction

Gliomas are the most common intrinsic tumours of the central nervous system and are graded according to the World Health Organization (WHO), from Grade-I to Grade-IV, with increasing malignancy.[1,2,3] The incidence of brain tumors has increased in recent several years, and the incidence shows significant difference in terms of gender, age, race, ethnicity, and even geographical region.[4]Paediatric brainstem gliomas (BSG) account for 10-20% of CNS neoplasms in children.[5]. They are characterized by infiltrative growth of tumor cells, including along white matter tracts.[6,7] Contrast enhanced MRI is the mainstay for imaging cerebral tumors.[8,9] The general prognosis for patients is

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Conclusion