1H MRS and DTI measures were assessed for their ability to predict the future growth and malignant transformation of low-grade gliomas. The tumour core NAA concentration and the mean diffusivity (MD) within the MRS voxel, combined with the FLAIR tumour volume, provided a good predictor of tumours with higher growth rates. A ROC analysis gave an AUC of 0.86 to predict tumours likely to undergo malignant progression, and AUC of 0.98 when including those undergoing early debulking. The combined NAA, MD and volumetric parameter provided a single time-point assessment of future growth characteristics.
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