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Susceptibility-Weighted Imaging in Preoperative Grading of Cerebral Gliomas

6. september 2026 opdateret af: Mohamed Salah El-din Sayed Atta, Assiut University

Diagnostic Value of Susceptibility-Weighted Imaging (SWI) in Preoperative Grading of Cerebral Gliomas

Gliomas are the most common primary brain tumors in adults. Determining whether a glioma is low-grade or high-grade before surgery is essential for surgical planning, choosing treatment pathways, and determining prognosis. Currently, definitive grading requires invasive tissue sampling through surgical resection or biopsy. Although conventional magnetic resonance imaging (MRI) is routinely performed, conventional sequences often show overlapping features between low-grade and high-grade tumors, limiting their ability to reliably predict tumor grade.

Susceptibility-weighted imaging (SWI) is an advanced MRI sequence sensitive to microscopic magnetic field distortions caused by blood products, calcification, and abnormal tumor blood vessels. On SWI, these features appear as intratumoral susceptibility signals (ITSS). Because high-grade gliomas typically display greater vascular proliferation and microhemorrhages than low-grade gliomas, quantifying ITSS may provide a non-invasive surrogate for tumor grade.

The primary purpose of this prospective observational study is to assess the diagnostic accuracy of SWI in the preoperative grading of cerebral gliomas, comparing imaging findings directly against histopathological examination according to the 2021 World Health Organization (WHO) Classification of Tumors of the Central Nervous System.

Adult participants with radiologically suspected cerebral gliomas who are scheduled for surgical resection or stereotactic biopsy will undergo a standardized preoperative brain MRI protocol. This protocol incorporates SWI alongside conventional MRI sequences, diffusion-weighted imaging (DWI/ADC), and magnetic resonance spectroscopy (MRS). Two independent radiologists blinded to pathology will assess and grade intratumoral susceptibility signals. Following surgery, imaging-predicted grades will be compared with the final tissue pathology to determine the sensitivity, specificity, and overall diagnostic accuracy of SWI.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Undersøgelsestype

Observationel

Tilmelding (Anslået)

90

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

N/A

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Adult patients presenting to Assiut University Hospital with radiologically suspected cerebral gliomas on initial neuroimaging (CT or MRI) who are referred to the Department of Diagnostic and Interventional Radiology in collaboration with the Department of Neurosurgery, and scheduled for subsequent surgical resection or stereotactic biopsy.

Beskrivelse

Inclusion Criteria:

  • Adult patients aged 18 years and older.
  • Neuroimaging (CT or MRI) findings suggestive of cerebral glioma.
  • Patients scheduled for surgical resection or stereotactic biopsy.

Exclusion Criteria:

  • Previous brain surgery for the same lesion.
  • Previous cranial radiotherapy or chemotherapy.
  • General contraindications to MRI (e.g., cardiac pacemakers, ferromagnetic implants, or severe claustrophobia).
  • Poor-quality MRI examinations compromised by significant motion or susceptibility artifacts.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Suspected Cerebral Glioma Cohort
Adult patients (≥18 years) presenting with radiologically suspected cerebral gliomas who are scheduled for surgical resection or stereotactic biopsy. All participants undergo a standardized preoperative brain MRI protocol incorporating conventional sequences (T1, T2, FLAIR, pre- and post-contrast T1), diffusion-weighted imaging (DWI/ADC), magnetic resonance spectroscopy (MRS), and 3D susceptibility-weighted imaging (SWI). Intratumoral susceptibility signals (ITSS) on SWI are graded semi-quantitatively (grades 0 to 3) to differentiate low-grade (grades 0-1) from high-grade (grades 2-3) tumors. Final tumor grading is established via histopathological examination of the surgical resection or stereotactic biopsy specimen according to the 2021 WHO Classification of Tumors of the Central Nervous System.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Diagnostic Accuracy of Susceptibility-Weighted Imaging (SWI)
Tidsramme: Baseline
Diagnostic accuracy is evaluated as the percentage of participants correctly categorized as having low-grade or high-grade cerebral gliomas using preoperative susceptibility-weighted imaging (SWI) intratumoral susceptibility signal (ITSS) grading, compared against the reference standard of histopathological examination according to the 2021 WHO Classification of Tumors of the Central Nervous System. ITSS is evaluated on a 4-point scale: Grade 0 (no ITSS), Grade 1 (1-5 dot-like/linear signals), Grade 2 (6-10 signals), and Grade 3 (>10 signals or confluent areas). Scores are dichotomized into low-grade (Grades 0-1) and high-grade (Grades 2-3) gliomas.
Baseline

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Assiut University

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. oktober 2026

Primær færdiggørelse (Anslået)

1. oktober 2027

Studieafslutning (Anslået)

1. november 2027

Datoer for studieregistrering

Først indsendt

6. september 2026

Først indsendt, der opfyldte QC-kriterier

6. september 2026

Først opslået (Faktiske)

10. september 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

10. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

6. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • SWI in Cerebral Glioma Grading

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