• Dirk Pauleit, Karl-Josef Langen, Frank Floeth, Hubertus Hautzel, Markus J Riemenschneider, Guido Reifenberger, N Jon Shah, and Hans-Wilhelm Müller.
• Clinic for Nuclear Medicine (KME), Research Center Jülich, Jülich, Germany. pauleit@web.de
• J Magn Reson Imaging. 2004 Nov 1; 20 (5): 758-64.

PurposeTo determine whether the apparent diffusion coefficient (ADC) can be used to distinguish between tumor tissue and peritumoral brain tissue in cerebral gliomas.Materials And MethodsTwenty-two patients with 44 biopsies were enrolled in this study. ADC maps calculated from a diffusion-weighted (DW) multislice EPI sequence were coregistered with conventional MR images. Neuronavigated biopsies and intraoperative markers were used for correlation with the histologic specimens. ADC values and lesion-to-brain ratios of the different sequences were calculated and compared for tumor tissue and peritumoral brain tissue. A logistic regression analysis was performed to determine the diagnostic value of the ADC maps.ResultsThe ADC values and ratios demonstrated a large overlap between tumor tissue and peritumoral tissue. Group comparisons revealed a significantly (P=0.03) lower ADC ratio in tumor tissue (mean=1.28 +/- 0.39) compared to peritumoral tissue (mean=1.48 +/- 0.30), whereas the absolute ADC values did not differ significantly. In the logistic regression analysis, the lesion-to-brain ratio of the gadolinium (Gd)-enhanced T1-weighted sequence was the most valuable predictor of the presence of tumor tissue. The ADC value and ratio were not identified as significant predictors.ConclusionThe ADC is not helpful for distinguishing tumor tissue from peritumoral brain tissue in gliomas.

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