Mean and normalized apparent diffusion coefficient values and mean metabolic ratios in cerebral metastases in central Indian rural hospital setup

Abstract

Background: To evaluate mean metabolite ratios and Apparent diffusion co-efficient value with normalization in cerebral metastases using MRS in rural hospital setup in Central India. Method: A cross sectional hospital based observational study conducted over a time period of 2 years. All the cases registered with Acharya Vinoba Bhave Rural Hospital ,Sawangi, Wardha, diagnosed on histopathological findings as cerebral metastases were included in this present study. All patients were examined on GE Brivo MRI machine with 1.5Tesla magnetic field strength in the Department of Radiodiagnosis using b value of 1000 s/sq. mm, slice thickness 5mm, interslice gap 2mm applied in the x, y and z axes, central as well as peripheral portions of the tumor were manually sampled, preferably getting rid of cystic or necrotic areas. Histopathological diagnostic acumen was augmented with ADC values with normalization. Result: Range of ADC values observed was from 0.683 10-3 mm2/s to 0.873 10-3 mm2/s. Normalized ADC values were calculated on basis of observed ADC values and were in range of 0.8537510-3 mm2/s to 1.09125 10-3 mm2/s. Mean ADC value was calculated as 0.749 x 10-3 mm2/s. Mean normalised ADC value was calculated to be 0.9372 x 10-3 mm2/s. Observed metabolite ratios were derived from metabolic values obtained on MRS for Choline, Creatinine, Lipid lactate, myoinositol and n-acetyl aspartate. Range for Choline:Creatinine, Choline:n-acetyl aspartate, choline : myoinositol and choline : lipid lactate was 3.97 to 5.73, 3.24 to 5.76, 4.35 to 5.49 and 0.32 to 0.997 respectively. Mean values for Choline:Creatinine, Choline:n-acetyl aspartate, choline : myoinositol and choline : lipid lactate were 4.1289, 3.7838, 4.1256 and 0.9095 respectively. Conclusion: Research gap analysis towards which research question was framed stands filled up by the generated new knowledge in terms of 'Mean metabolite ratios','Apparent Diffusion Coefficient' and 'Normalised Apparent Diffusion Coefficient' values for cerebral metastases in the present study.