GRADING AND STAGING OF BRAIN TUMOR ON MRI AN ANALYTICAL EXAMINATION WITH HISTOPATHALOGICALCORRELATION: A DESCRIPTIVE CROSS-SECTIONAL STUDY

Abstract

Background: Brain tumors remain a major contributor to neurological morbidity and mortality worldwide, with outcomes largely dependent on timely diagnosis and accurate grading. Tumor grading reflects cellular differentiation and biological aggressiveness, whereas staging evaluates anatomical extent and spread. Preoperative radiological assessment, particularly magnetic resonance imaging (MRI), plays a pivotal role in guiding clinical management. However, correlation between imaging characteristics and histopathological grading remains essential to validate non-invasive diagnostic reliability.

Objective: To evaluate the role of radiological imaging in the grading and staging of brain tumors and to determine its correlation with histopathological findings based on the World Health Organization (WHO) classification.

Methods: This descriptive cross-sectional study was conducted at selected tertiary care hospitals over a defined study period. A total of 50 patients with radiologically suspected primary brain tumors were enrolled using non-probability convenience sampling. Patients with incomplete imaging records or secondary metastatic lesions were excluded. Data were collected through structured proformas documenting demographic variables, tumor location, size, margins, contrast enhancement patterns, necrosis, peritumoral edema, and mass effect. MRI was the primary imaging modality, supplemented by computed tomography (CT) where clinically indicated. Histopathological grading was performed according to the WHO classification system (Grades I–IV) following surgical resection or biopsy. Statistical analysis was conducted using SPSS version 25. Descriptive statistics were calculated as frequencies and percentages, and imaging characteristics were compared with histopathological grades to determine correlation patterns.

Results: The study included 50 patients with a mean age of 44.2 ± 13.6 years; 28 (56%) were male and 22 (44%) were female. Supratentorial tumors accounted for 41 cases (82%), while 9 (18%) were infratentorial. Histopathological evaluation revealed 8 (16%) Grade I tumors, 10 (20%) Grade II tumors, 17 (34%) Grade III tumors, and 15 (30%) Grade IV tumors, indicating a predominance of high-grade lesions (64%). Irregular tumor margins were observed in 32 patients (64%), heterogeneous contrast enhancement in 29 (58%), central necrosis in 24 (48%), and significant peritumoral edema in 35 (70%). Among high-grade tumors (Grades III–IV), 26 of 32 cases (81.3%) demonstrated heterogeneous enhancement and 28 of 32 (87.5%) exhibited marked edema. In contrast, low-grade tumors (Grades I–II) more commonly presented with well-defined margins (12 of 18; 66.7%) and minimal or no enhancement (10 of 18; 55.6%). A strong concordance was observed between radiological grading indicators and histopathological diagnosis, supporting the predictive value of imaging characteristics in determining tumor aggressiveness.

Conclusion: Radiological imaging, particularly MRI, demonstrated substantial reliability in the preoperative grading and anatomical assessment of brain tumors. Imaging features such as enhancement pattern, necrosis, and peritumoral edema showed strong correlation with histopathological grade, underscoring MRI’s critical role as a non-invasive tool for clinical decision-making, treatment planning, and prognostic evaluation.