Comparison between ultra-high and conventional mono b-value DWI for preoperative glioma grading

To compare the efficacy of ultra-high and conventional mono-b-value DWI for glioma grading, in 109 pathologically confirmed glioma patients, ultra-high apparent diffusion coefficient (ADC(uh))was calculated using a tri-exponential mode, distributed diffusion coefficients (DDCs) and α values were calculated using a stretched-exponential model, and conventional ADC values were calculated using a mono-exponential model. The efficacy and reliability of parameters for grading gliomas were investigated using receiver operating characteristic (ROC) curve and intra-class correlation (ICC) analyses, respectively. The ADC(uh) values differed (P < 0.001) between low-grade gliomas (LGGs; 0.436 ×10(−3) mm(2)/sec) and high-grade gliomas (HGGs; 0.285 × 10(−3) mm(2)/sec). DDC, a and various conventional ADC values were smaller in HGGs (all P ≤ 0.001, vs. LGGs). The ADC(uh) parameter achieved the highest diagnostic efficacy with an area under curve (AUC) of 0.993, 92.9% sensitivity and 98.8% specificity for glioma grading at a cutoff value of 0.362×10(−3) mm(2)/sec. ADC(uh) measurement appears to be an easy-to-perform technique with good reproducibility (ICC = 0.9391, P < 0.001). The ADC(uh) value based in a tri-exponential model exhibited greater efficacy and reliability than other DWI parameters, making it a promising technique for glioma grading.