Clinical radiology
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To detect a difference in the parameters derived from proton magnetic resonance spectroscopy ((1)H-MRS) and diffusion tensor imaging (DTI) between low-grade and high-grade gliomas, and to evaluate whether the combination of these two techniques can improve the diagnostic accuracy of conventional magnetic resonance imaging (MRI) in supratentorial glioma grading. ⋯ Thresholds for NAA/Cho and calculated ADC values, corresponding to maximum Youden index from ROC curve analyses, helped to improve the accuracy of supratentorial glioma grading when compared with conventional MRI alone. In addition, a combination of NAA/Cho and ADC calculation were more useful together than each alone in a clinical setting to evaluate glioma grade preoperatively and provide a means for guiding treatment.