Integrating Diffusion-weighted and Perfusion-weighted Imaging for Improved Grading and Characterization of Brain Tumors

Objective: This study aims to evaluate the role of Diffusion-Weighted Imaging (DWI) and Perfusion-Weighted Imaging (PWI) in the detection, characterization, and grading of brain tumors, focusing on their correlation with histopathological findings. Materials and Methods: A total of 40 patients with intracranial mass lesions underwent DWI, PWI, and conventional MRI using a 1.5 Tesla MRI scanner. Apparent Diffusion Coefficient (ADC) values were calculated for tumor core, peritumoral edema, and normal brain tissue. Cerebral Blood Volume (CBV), Cerebral Blood Flow (CBF), and Mean Transit Time (MTT) were analyzed using PWI. Data were statistically analyzed, with a p-value ≤ 0.05 considered significant. Results: The study included 38 neoplastic lesions and 2 tuberculomas. DWI showed distinct ADC values for different tumors, with meningiomas having a mean ADC of 0.84 ± 0.3 × 10⁻³ mm²/s and schwannomas a higher ADC of 2.14 × 10⁻³ mm²/s. PWI revealed elevated relative CBV in high-grade gliomas (mean: 2.1 ± 0.76), while lower rCBV was observed in metastases (mean: 0.5 ± 0.26). Tuberculomas exhibited intermediate perfusion characteristics. Conclusion: DWI and PWI, in conjunction with conventional MRI, enhance the diagnostic accuracy for brain tumors by providing valuable information on tumor cellularity and vascularity. These techniques aid in distinguishing between tumor types, grades, and associated edema, thus improving clinical decision-making and treatment planning.