Kamboh Ua, Adnan Ha, Shahzad M, Anwar A.
Comparison Of Histopathologic Features With Pre Operative Magnetic Resonance Imaging And Magnetic Resonance Spectroscopy Diagnosis Of Primary Brain Tumors.
Biomedica Jan ;34(1):20-6.

Background and Objective: Brain tumours account for major portion of neurosurgical disease burden. The outcome of the patient depends on preoperative neurologic deficits and imaging features in magnetic resonance imaging which is very helpful for evaluation of brain tumours. Magnetic resonance spectroscopy is even more beneficial in making a plan for extent of resection. The present study was designned to compare the histopathological diagnosis using pre-operative Magnetic resonance imaging (MRI) and Magnetic resonance spectroscopy (MRS) diagnosis for primary brain tumors and to find if one technique is better than the other. Methods: This study was conducted at Neurosurgery department Jinnah Hospital Lahore in collaboration with the Pathology department, Allama Iqbal medical college and Radiology department Jinnah Hospital Lahore from January 2014 to December 2016. Fifty patients provisionally diagnosed as low and high grade primary brain tumor on MRI and MRS were included in the study before surgical biopsy or resection. Tissue for histopathology was obtained via biopsy or resection and all enrolled tumors were graded according to WHO criteria. Histopathological diagnosis was compared with the pre-operative diagnosis after application of Chi square test. The sensitivity, specificity, positive predictive value and negative predictive value of MRI and MRS were also calculated in radiological diagnosis characterization. Results: The age of patients ranged from 4 to 62 years. Out of the total, 30 (60%) patients were male and 20 (40%) were female. Among all, 35 (70%) patients were having supratentorial brain tumors and 15 (30%) as infratentorial brain tumors. MRI and MRS revealed 20 (57.2%) patients of supratentorial group had Glioma features and among them 13 (65%) had high grade while 7 (35%) were low grade. Among infratentorial group, 9 (60%) patients had medulloblastoma features with 7 (77.8%) patients having high grade and 2 (22.2%) patients have low grade. These MRI and MRS features were compared with histopathological diagnosis and no significant difference was found (p-value > 0.05). Sensitivity, specificity, positive predictive value and negative predictive value of MRI and MRS in detecting tumor necrosis were 95 %, 74%, 77% and 90% respectively. Conclusion: Pre-operative MRI and MRS are effective in accurate characterization of primary brain tumors which was confirmed by histopathology.

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