Grading of Brain Tumors in Children: Comparative Study between Using Diffusion-Weighted Imaging and 1H-MR Spectroscopy

Ph.D.**; MANAL M. REFAAT BESHIR, M.D., Ph.D.* And MOHSEN AHMED ABDELMOHSEN, M.D., Ph.D.*,***, MAHMOUD M.A. REZK, M.D., Ph.D.*; AYDA A. YOUSEF, M.D., Ph.D.**; DALIA I. MOHAMED, M.D.,

doi:10.21608/mjcu.2025.464481

Grading of Brain Tumors in Children: Comparative Study between Using Diffusion-Weighted Imaging and 1H-MR Spectroscopy

Document Type : Original Article

Author

MAHMOUD M.A. REZK, M.D., Ph.D.*; AYDA A. YOUSEF, M.D., Ph.D.**; DALIA I. MOHAMED, M.D., Ph.D.**; MANAL M. REFAAT BESHIR, M.D., Ph.D.* and MOHSEN AHMED ABDELMOHSEN, M.D., Ph.D.*,***

The Department of Radio-Diagnosis, National Cancer Institute, Cairo University*, Department of Radio-Diagnosis, Faculties of Medicine, Cairo** and Alexandria*,*** Universities

10.21608/mjcu.2025.464481

Abstract

Background: Accurate initial diagnosis and grading of the brain tumors is highly affecting choice of treatment, long-term prognosis, and quality of life in survivors. Conventional MRI has a limited accuracy in the tumor grading; that role is re-served for histopathologic evaluation after biopsy. Diffusion weighted image (DWI) and MR spectroscopy (MRS) are used as a non-invasive imaging tools for tumor grading. Thus, the purpose of our study was to compare the effectiveness of both techniques. Aim of Study: The aim of our study was to answer a ques-tion that appeared in clinical practice: Which technique (Dif-fusion-Weighted Imaging or 1H-MR Spectroscopy) is more accurate for grading brain tumors in children, or whether both techniques should be used in a combined manner. Patients and Methods: 100 child with brain tumors were investigated with conventional MRI, DWI, and MRS. The ap-parent diffusion coefficient (ADC) and spectroscopic metabo-lites values were retrieved and compared with the tumor grade based on the World Health Organization (WHO) classification of brain tumors. Results: Average ADC value of the tumors is more ac-curate than the spectroscopic metabolite values in grading of brain tumors in the children. Average ADC value had high per-formance in detection of the tumor grade reaching 96.2% with 0.95 x10-3 mm2/sec is a cutoff value between the high and low grade by sensitivity 90.9% and specificity 91% [15,20]. On other side the probability of Ch/NAA ratio of the lesion is 86% with 7.4 is a cutoff value between the high- and low-grade tumor by sensitivity 23% and specificity 50%. Conclusion: Calculated ADC value is more accurate and sensitive than the MRS as non-invasive methods to predict the brain tumor grade in children.

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