Apparent diffusion coefficient of pediatric cerebellar tumors: A biomarker of tumor grade?

Authors

  • Andrea Poretti MD,

    1. Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
    2. Division of Pediatric Neurology, University Children's Hospital, Zurich, Switzerland
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  • Avner Meoded MD,

    1. Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
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  • Kenneth J. Cohen MD,

    1. Division of Pediatric Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, The Johns Hopkins University School of Medicine, Baltimore, MD
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  • Michael A. Grotzer MD,

    1. Division of Pediatric Oncology, University Children's Hospital, Zurich, Switzerland
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  • Eugen Boltshauser MD,

    1. Division of Pediatric Neurology, University Children's Hospital, Zurich, Switzerland
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  • Thierry A.G.M. Huisman MD

    Corresponding author
    • Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
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  • Conflict of interest: Nothing to declare.

Correspondence to: Thierry A.G.M. Huisman, EQNR, FICIS, Professor of Radiology and Pediatrics, Director Pediatric Radiology and Pediatric Neuroradiology, 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.

E-mail: thuisma1@jhmi.edu

Abstract

Background

The role of diffusion weighted imaging (DWI) to reliably differentiate tumor types and grades in pediatric cerebellar tumors is controversial. We aimed to clarify the discrepancy reported in previous articles.

Procedures

We retrospectively evaluated the apparent diffusion coefficient (ADC) values of the enhancing, solid parts of cerebellar tumors and correlated the absolute tumor ADC values and cerebellar and thalamic ratios with histology in a cohort of children with cerebellar tumors.

Results

Twenty-four children (12 females) were included in the study. The median age at pre-surgical MRI was 10 years (range 29 days–18.5 years). Absolute ADC values (mean 1.49, SD 0.25 vs. 0.63 ± 0.18), cerebellar (2.04 ± 0.33 vs. 0.83 ± 0.25), and thalamic ratio (1.98 ± 0.35 vs. 0.79 ± 0.23) were significantly higher in low- than in high-grade tumors (P < 0.0001). Absolute ADC values and cerebellar and thalamic ratios were significantly higher in low-grade astrocytomas than in MBs. Overlap was seen for WHO grade II and III ependymomas. One hundred percent specific cutoff ADC values of >1.2 × 103 and <0.8 × 10−3 mm2/s were established for low- and high-grade tumors.

Conclusion

ADC analysis of the solid, contrast enhancing components of pediatric cerebellar tumors may facilitate differentiation between various tumor histologies. Pediatr Blood Cancer 2013;60:2036–2041. © 2013 Wiley Periodicals, Inc.

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