Clinical Investigative Study

Pediatric Cerebellar Tumors: Does ADC Analysis of Solid, Contrast-Enhancing Tumor Components Correlate Better with Tumor Grade than ADC Analysis of the Entire Tumor?

Gunes Orman MD

Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD

Search for more papers by this author

Thangamadhan Bosemani MD,

Thangamadhan Bosemani MD

Search for more papers by this author

Luke Higgins MD, PhD,

Luke Higgins MD, PhD

Search for more papers by this author

Kathryn A. Carson ScM,

Kathryn A. Carson ScM

Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

Division of General Internal Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD

Search for more papers by this author

Thierry A.G.M. Huisman MD,

Thierry A.G.M. Huisman MD

Search for more papers by this author

Andrea Poretti MD,

Corresponding Author

Andrea Poretti MD

Correspondence: Address correspondence to Andrea Poretti, MD, Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Charlotte R. Bloomberg Children's Center, Sheikh Zayed Tower, Room 4174, 1800 Orleans Street, Baltimore, MD 21287-0842, USA. E-mail: [email protected].Search for more papers by this author

Gunes Orman MD,

Gunes Orman MD

Search for more papers by this author

Thangamadhan Bosemani MD,

Thangamadhan Bosemani MD

Search for more papers by this author

Luke Higgins MD, PhD,

Luke Higgins MD, PhD

Search for more papers by this author

Kathryn A. Carson ScM,

Kathryn A. Carson ScM

Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

Division of General Internal Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD

Search for more papers by this author

Thierry A.G.M. Huisman MD,

Thierry A.G.M. Huisman MD

Search for more papers by this author

Andrea Poretti MD,

Corresponding Author

Andrea Poretti MD

First published: 16 December 2014

https://doi.org/10.1111/jon.12199

Citations: 9

Conflict of Interest: The authors declare that they have no conflict of interest.

Share a link

Email
Wechat
Bluesky

ABSTRACT

BACKGROUND

Apparent diffusion coefficient (ADC) values assist differentiating malignancy grades in pediatric cerebellar tumors. Previous studies reported the significance of ADC measurements within the solid, contrast-enhancing tumor component (SCT). These measurements take into account only a part of the tumor. In this study, we compared ADC measurements of the SCT versus entire tumor (ET).

METHODS

ADC values were measured in the SCT and ET. Absolute tumor ADC values and cerebellar and thalamic ratios were compared across tumor grades.

RESULTS

Thirty-two children with 16 low-grade and 16 high-grade tumors were included. The median age at presurgical MRI was 7.66 years (range .08-17.38 years). In the SCT, absolute ADC values, cerebellar ratio, and thalamic ratio were higher in low- versus high-grade tumors (P < .001). In the ET, absolute ADC values, cerebellar ratio, and thalamic ratio were also higher in low- versus high-grade tumors (P < .005). Cut-off absolute ADC values of .9 × 10⁻³ mm/s² (sensitivity 94%, specificity 100%) and 1.5 × 10⁻³ mm/s² (sensitivity 88%, specificity 75%) were calculated for measurement in the SCT and ET, respectively, to differentiate between tumors grades.

CONCLUSION

A rigorous ADC measurement of the SCT has a higher sensitivity and specificity in predicting tumor grade compared to ADC measurement of the ET.

References

1Baldwin RT, Preston-Martin S. Epidemiology of brain tumors in childhood–a review. Toxicol Appl Pharmacol 2004; 199: 118-131.
10.1016/j.taap.2003.12.029
CAS PubMed Web of Science® Google Scholar
2Pollack IF. Brain tumors in children. N Engl J Med 1994; 331: 1500-1507.
10.1056/NEJM199412013312207
CAS PubMed Web of Science® Google Scholar
3Poretti A, Meoded A, Huisman TA. Neuroimaging of pediatric posterior fossa tumors including review of the literature. J Magn Reson Imaging 2012; 35: 32-47.
10.1002/jmri.22722
CAS PubMed Web of Science® Google Scholar
4Gauvain KM, McKinstry RC, Mukherjee P, et al. Evaluating pediatric brain tumor cellularity with diffusion-tensor imaging. Am J Roentgenol 2001; 177: 449-454.
10.2214/ajr.177.2.1770449
CAS PubMed Web of Science® Google Scholar
5Rumboldt Z, Camacho DL, Lake D, et al. Apparent diffusion coefficients for differentiation of cerebellar tumors in children. AJNR 2006; 27: 1362-1369.
CAS PubMed Web of Science® Google Scholar
6Schneider JF, Confort-Gouny S, Viola A, et al. Multiparametric differentiation of posterior fossa tumors in children using diffusion-weighted imaging and short echo-time 1H-MR spectroscopy. J Magn Reson Imaging 2007; 26: 1390-1398.
10.1002/jmri.21185
CAS PubMed Web of Science® Google Scholar
7Jaremko JL, Jans LB, Coleman LT, et al. Value and limitations of diffusion-weighted imaging in grading and diagnosis of pediatric posterior fossa tumors. AJNR 2010; 31: 1613-1616.
10.3174/ajnr.A2155
CAS PubMed Web of Science® Google Scholar
8Pillai S, Singhal A, Byrne AT, et al. Diffusion-weighted imaging and pathological correlation in pediatric medulloblastomas-“they are not always restricted!” Child Nerv Syst 2011; 27: 1407-1411.
10.1007/s00381-011-1499-5
PubMed Web of Science® Google Scholar
9Gimi B, Cederberg K, Derinkuyu B, et al. Utility of apparent diffusion coefficient ratios in distinguishing common pediatric cerebellar tumors. Acad Radiol 2012; 19: 794-800.
10.1016/j.acra.2012.03.004
PubMed Web of Science® Google Scholar
10Poretti A, Meoded A, Cohen KJ, et al. Apparent diffusion coefficient of pediatric cerebellar tumors: a biomarker of tumor grade? Pediatr Blood Cancer 2013; 60: 2036-2041.
10.1002/pbc.24578
PubMed Web of Science® Google Scholar
11Koral K, Mathis D, Gimi B, et al. Common pediatric cerebellar tumors: correlation between cell densities and apparent diffusion coefficient metrics. Radiology 2013; 268: 532-537.
10.1148/radiol.13121362
PubMed Web of Science® Google Scholar
12Koral K, Zhang S, Gargan L, et al. Diffusion MRI improves the accuracy of preoperative diagnosis of common pediatric cerebellar tumors among reviewers with different experience levels. AJNR 2013; 34: 2360-2365.
10.3174/ajnr.A3596
CAS PubMed Web of Science® Google Scholar
13Huisman TA. Diffusion-weighted imaging: basic concepts and application in cerebral stroke and head trauma. Eur Radiol 2003; 13: 2283-2297.
10.1007/s00330-003-1843-6
PubMed Web of Science® Google Scholar
14Poussaint TY, Rodriguez D. Advanced neuroimaging of pediatric brain tumors: MR diffusion, MR perfusion, and MR spectroscopy. Neuroimag Clin N Am 2006; 16: 169-192.
10.1016/j.nic.2005.11.005
PubMed Web of Science® Google Scholar
15Kan P, Liu JK, Hedlund G, et al. The role of diffusion-weighted magnetic resonance imaging in pediatric brain tumors. Child Nerv Syst 2006; 22: 1435-1439.
10.1007/s00381-006-0229-x
PubMed Web of Science® Google Scholar
16Rossi A, Gandolfo C, Morana G, et al. New MR sequences (diffusion, perfusion, spectroscopy) in brain tumours. Pediatr Radiol 2010; 40: 999-1009.
10.1007/s00247-010-1613-y
PubMed Web of Science® Google Scholar
17Bull JG, Saunders DE, Clark CA. Discrimination of paediatric brain tumours using apparent diffusion coefficient histograms. Eur Radiol 2012; 22: 447-457.
10.1007/s00330-011-2255-7
PubMed Web of Science® Google Scholar
18Morita K, Matsuzawa H, Fujii Y, et al. Diffusion tensor analysis of peritumoral edema using lambda chart analysis indicative of the heterogeneity of the microstructure within edema. J Neurosurg 2005; 102: 336-341.
10.3171/jns.2005.102.2.0336
PubMed Web of Science® Google Scholar
19Guzman R, Altrichter S, El-Koussy M, et al. Contribution of the apparent diffusion coefficient in perilesional edema for the assessment of brain tumors. J Neuroradiol 2008; 35: 224-229.
10.1016/j.neurad.2008.02.003
CAS PubMed Web of Science® Google Scholar
20Server A, Kulle B, Maehlen J, et al. Quantitative apparent diffusion coefficients in the characterization of brain tumors and associated peritumoral edema. Acta Radiol 2009; 50: 682-689.
10.1080/02841850902933123
CAS PubMed Web of Science® Google Scholar
21Asao C, Korogi Y, Kitajima M, et al. Diffusion-weighted imaging of radiation-induced brain injury for differentiation from tumor recurrence. AJNR 2005; 26: 1455-1460.
PubMed Web of Science® Google Scholar
22Sundgren PC, Fan X, Weybright P, et al. Differentiation of recurrent brain tumor versus radiation injury using diffusion tensor imaging in patients with new contrast-enhancing lesions. Magn Reson Imaging 2006; 24: 1131-1142.
10.1016/j.mri.2006.07.008
CAS PubMed Web of Science® Google Scholar
23Chenevert TL, McKeever PE, Ross BD. Monitoring early response of experimental brain tumors to therapy using diffusion magnetic resonance imaging. Clin Cancer Res 1997; 3: 1457-1466.
CAS PubMed Web of Science® Google Scholar
24Provenzale JM, Mukundan S, Barboriak DP. Diffusion-weighted and perfusion MR imaging for brain tumor characterization and assessment of treatment response. Radiology 2006; 239: 632-649.
10.1148/radiol.2393042031
PubMed Web of Science® Google Scholar
25Chenevert TL, Ross BD. Diffusion imaging for therapy response assessment of brain tumor. Neuroimag Clin N Am 2009; 19: 559-571.
10.1016/j.nic.2009.08.009
PubMed Web of Science® Google Scholar
26Kumar R, Achari G, Banerjee D, et al. Uncommon presentation of medulloblastoma. Child Nerv Syst 2001; 17: 538-542; discussion 543.
10.1007/s003810100446
CAS PubMed Web of Science® Google Scholar
27Nelson M, Diebler C, Forbes WS. Paediatric medulloblastoma: atypical CT features at presentation in the SIOP II trial. Neuroradiology 1991; 33: 140-142.
10.1007/BF00588252
CAS PubMed Web of Science® Google Scholar
28Tortori-Donati P, Fondelli MP, Rossi A, et al. Medulloblastoma in children: CT and MRI findings. Neuroradiology 1996; 38: 352-359.
10.1007/BF00596587
CAS PubMed Web of Science® Google Scholar
29Centeno RS, Lee AA, Winter J, et al. Supratentorial ependymomas. Neuroimaging and clinicopathological correlation. J Neurosurg 1986; 64: 209-215.
10.3171/jns.1986.64.2.0209
CAS PubMed Web of Science® Google Scholar

Citing Literature

Volume25, Issue5

September/October 2015

Pages 785-791

Pediatric Cerebellar Tumors: Does ADC Analysis of Solid, Contrast-Enhancing Tumor Components Correlate Better with Tumor Grade than ADC Analysis of the Entire Tumor?

ABSTRACT

BACKGROUND

METHODS

RESULTS

CONCLUSION

References

Citing Literature

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Pediatric Cerebellar Tumors: Does ADC Analysis of Solid, Contrast-Enhancing Tumor Components Correlate Better with Tumor Grade than ADC Analysis of the Entire Tumor?

ABSTRACT

BACKGROUND

METHODS

RESULTS

CONCLUSION

References

Citing Literature

References

Related

Information