Differentiating Giant Cell Glioblastoma from Classic Glioblastoma With Diffusion-Weighted Imaging

BACKGROUND: Differential diagnosis of giant cell glioblastoma (GC) and classic glioblastoma (GBM) using conventional radiological modalities is difficult. This study aimed to use diffusion-weighted imaging (DWI) to distinguish GC from GBM and thereby improve the accuracy of preoperative assessment of patients with GB. METHODS: The clinical, magnetic resonance imaging, and pathologic data of 12 patients with GC and 21 patients with GBM were retrospectively analyzed. Independent sample t tests were used to compare the minimum apparent diffusion coefficient (ADCmin) and the normalized apparent diffusion coefficients (nADC) of the 2 tumor types. Receiver operating curve (ROC) analysis was used to assess the diagnostic efficacy of ADCmin and nADC values. RESULTS: Compared with that of the classic GBM group, the ADC(min) (0.98 +/- 0.14 vs. 0.80 +/- 0.19x10(-3) mm(2)/second, P = 0.007) and nADC (1.42 +/- 0.25 vs. 1.17 +/- 0.25, P = 0.011) of the GC group were significantly higher. ROC curve analysis showed that the maximum area under the curve of ADCmin and nADC were 0.800 +/- 0.080 and 0.778 +/- 0.082, respectively. The sensitivity, specificity, and accuracy distinguishing GC and classic GBM was best (83.33%, 76.19%, and 78.79%, respectively) when ADC(min) = 0.84x10(-3) mm(2)/second (maximum area under the ROC, 0.800). Its positive and negative predictive values under this condition were 88.89% and 66.67%, respectively. CONCLUSIONS: By distinguishing GC from classic GBM, the ADC(minyyy) parameter of DWI can improve the accuracy of the preoperative differential diagnosis of the 2 tumor types.

Automated summary

This study used diffusion-weighted imaging (DWI) to distinguish giant cell glioblastoma (GC) from classic glioblastoma (GBM), showing that the ADC(min) parameter can improve the accuracy of preoperative differential diagnosis of the two tumor types.