Hubungan Diffusion-Weighted Imaging (DWI) dan Nilai Apparent Diffusion Coefficient (ADC) dengan Grading Glioma Otak di RS Adam Malik

Abstract

Objective: To analyze the correlation between qualitative Diffusion-Weighted Imaging (DWI) features and quantitative Apparent Diffusion Coefficient (ADC) values on pre-operative MRI with the histopathological grading of gliomas at RSUP H. Adam Malik. Methods: This retrospective cross-sectional study analyzed 33 adult glioma patients at RSUP H. Adam Malik (August 2021-November 2024) who had pre-operative MRI (including DWI b=0/1000 s/mm²) and definitive histopathology results. DWI images were qualitatively assessed (restricted/unrestricted diffusion). Mean ADC values were measured quantitatively from solid tumor regions using ROIs. WHO grading (Low-Grade vs. High-Grade) was determined from histopathology. The relationship between DWI/ADC and grading was statistically analyzed. Results: Of the 33 patients (15 Low-Grade Glioma/LGG, 18 High-Grade Glioma/HGG), significant differences in DWI features were found (p<0.001). Majority of LGG (11/15; 73.3%) showed unrestricted diffusion, whereas the majority of HGG (16/18; 88.9%) showed restricted diffusion. Quantitatively, the mean ADC value in the LGG group (1.58±0.52×10−3 mm2/s) was significantly higher than in the HGG group (1.01±0.51×10−3 mm2/s). Correlation analysis (Eta test) confirmed a very strong relationship between glioma grading and both qualitative DWI features (Eta=0.978) and quantitative mean ADC values (Eta=0.803). Conclusion: There is a strong correlation between qualitative DWI features and quantitative ADC values on MRI with the histopathological grading of gliomas. High-grade gliomas tend to show restricted diffusion with low ADC values, contrasting with low-grade gliomas, establishing DWI and ADC parameters as valuable non-invasive imaging biomarkers that can aid in the pre-operative differentiation of glioma grades and support optimal pre-operative clinical assessment.