The Role of BT-RADS Scoring System in Post Treatment Assessment of Brain Gliomas

Abstract Background Brain tumors are a diverse group of neoplasms that are a source of substantial morbidity and mortality worldwide. Gliomas constitute most of the primary malignant brain tumors, with the most aggressive as well as most common form in adults, grade IV glioma or glioblastoma multiforme, carrying an especially poor prognosis. Neuroimaging plays a crucial role in the diagnosis and management of patients with gliomas that requires complex multi-specialty treatment. Objective To evaluate the added value of applying BT-RADS scoring system on post- treatment imaging follow up in patients with gliomas. Patients and Methods this study is a retrospective study and the study was conducted at Ain Shams University Hospitals, Radiodiagnosis department. The study period 9-12 months. Included Patients with histopathologically proven brain glioma. Results Implementation of the BT-RADS scoring system in post-treatment assessment of brain gliomas and studying its diagnostic performance showed that the 6 months post treatment BT-RADS score had the highest diagnostic performance with higher AUC, sensitivity, specificity, PPV, NPV and Accuracy of 0.861 (0.740 to 0.940), 77.8%, 94.4%, 87.5%, 89.5% respectively followed by the BT-RADS at 3 months with AUC=0.806 (0.675 to 0.901), sensitivity of 72.2%, specificity of 88.9%, PPV of 78.5%, NPV of 88.5% and Accuracy of 83.3%. The Diagnostic performance of the individual criteria of the BT-RADS scoring system, including (Enhancement, FLAIR and Mass effect) showed that the enhancement criteria had a higher diagnostic performance than the FLAIR, and the mass effect criteria with a higher AUC of 0.819 (0.691 to 0.911), and a higher sensitivity, specificity, PPV, NPV and accuracy of 72.2%, 91.7%, 81.3%, 94.3%, and 85.2% respectively. While both FLAIR and mass effect showed the same diagnostic performance with AUC=0.806 (0.675 to 0.901), and sensitivity of 72.2%, specificity of 88.9%, PPV of 76.5%, NPV of 86.5%, and accuracy of 83.3% Conclusion In our study we implemented the BT-RADS scoring system on 54 patients of brain gliomas and studied the diagnostic performance of BT-RADS scoring system in the early and accurate detection of tumor progression and showed high sensitivity and specificity in prediction of tumor progression in relation to patients’ outcome at 12 months (Gold standard).