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Abstract
Background
Intra-axial gliomas are among the most common primary brain tumors and are associated with considerable morbidity and mortality. Early and accurate diagnosis is essential for appropriate treatment planning and improved patient outcomes. Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluating suspected gliomas; however, histopathological examination remains the gold standard for definitive diagnosis.
Methodology
A hospital-based cross-sectional validation study was conducted in the Department of Radiology, Khyber Teaching Hospital, from 14 November 2024 to 14 February 2025. A total of 86 patients aged 18–75 years with clinically suspected intra-axial gliomas were enrolled using consecutive non-probability sampling. All participants underwent brain MRI followed by histopathological examination of biopsy or surgical specimens. Histopathological findings served as the reference standard. Data were analyzed using SPSS version 25. Diagnostic indices including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy were calculated.
Results
Among 86 participants, histopathology confirmed intra-axial gliomas in 50 (58.1%) patients. MRI demonstrated 45 true-positive, 29 true-negative, 7 false-positive, and 5 false-negative cases. The sensitivity, specificity, PPV, NPV, and overall diagnostic accuracy of MRI were 90.0%, 80.6%, 86.5%, 85.3%, and 86.0%, respectively. MRI findings showed a statistically significant association with histopathological diagnosis (Chi-square = 48.62, p < 0.001).
Conclusion
Magnetic resonance imaging demonstrated high diagnostic accuracy in detecting intra-axial gliomas and showed strong agreement with histopathological findings. MRI is a reliable non-invasive modality for the preoperative evaluation of suspected gliomas and should remain the primary imaging investigation, while histopathology continues to serve as the definitive diagnostic standard.