Neuroimaging of pediatric infratentorial tumors and the value of diffusion-weighted imaging (DWI) in determining tumor grade

Author:

Sathyakumar Kirthi1ORCID,Mani Sunithi1,Pathak Gayatri Harshe1,Prabhu Krishna2ORCID,Chacko Ari George2,Chacko Geeta3

Affiliation:

1. Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India

2. Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India

3. Department of Pathology, Christian Medical College, Vellore, Tamil Nadu, India

Abstract

Background Diffusion-weighted imaging (DWI) provides information about the cellular density of tumors. This feature is useful in grading and identifying different tumor types. Purpose To assess the value of diffusion restriction and apparent diffusion coefficient (ADC) values in differentiating pediatric infratentorial tumors. Material and Methods This was a retrospective review of the magnetic resonance imaging (MRI) of 82 children (age range 1–16 years) with infratentorial tumors. Histopathological grading after surgical excision/biopsy was categorized as low grade (WHO grades I and II) (n = 31; 29 pilocytic astrocytomas, 2 ependymomas) and high grade (WHO grade III and IV) (n = 51; 40 medulloblastomas, 8 anaplastic ependymomas, 1 anaplastic astrocytoma, 2 atypical rhabdoid teratoid tumors [ATRT]). MRI features and ADC values were compared among tumor types and grades using a two-tailed t test, Mann–Whitney U test for continuous data and Chi-square test for categorical variables. Results Diffusion restriction and low ADC value was a feature of high-grade tumors ( P<0.001). The mean ADC values of the low-grade and high-grade tumors were 1.567 × 10−3mm2/s and 0.661 × 10−3mm2/s, respectively. Using 0.9 × 10−3mm2/s as the cut-off value, the sensitivity, specificity, positive and negative predictive values for differentiating the grades was 87%, 100%, 100%, and 81.8%, respectively. Significant differences were found between the mean ADC values of the individual tumor types ( P<0.05), except between medulloblastoma and ATRT. Conclusion ADC values and visual assessment of diffusion restriction are useful in tumor grading. The individual tumor types can be identified by an algorithmic approach, using DWI in conjunction with other described MRI features.

Publisher

SAGE Publications

Subject

Radiology Nuclear Medicine and imaging,General Medicine,Radiological and Ultrasound Technology

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3