Apparent diffusion coefficients in evaluation of pediatric brain tumors
Lojana Tuntiyatorn1, Bordin Nantawas, Nongnuch Sirachainan
1Division of Neuroradiology, Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. lojana.tun@mahidol.ac.th
Background:
MRI, which has high sensitivity in brain tumor detection, cannot reliably determine tumor grading or histology. Diffusion-weighted imaging and apparent diffusion coefficients (ADCs) provide information of tumor cellularity that can correlate with grading.
Objective:
To investigate ADCs in differentiation low-grade from high-grade pediatric brain tumors.
Material And Method:
Preoperative MRI, DWI, and ADC images of pediatric patients with pathologically proven brain tumors were retrospectively reviewed at a university hospital in two-year periods and classified into low-grade and high-grade categories. Regions of interest were placed manually at the center and periphery of the solid tumor regions, then ADC values were calculated at "b" values = 0, 1000 sec/mm2.
Results:
The ADC values were calculated in 15 patients, which included 12 males and three females with an age range from three to 14 years. Seven and eight were with low- and high-grade tumors respectively. The ADC values of low-grade tumors were markedly higher than those of high-grade tumors with statistically significant differences by all methods of measurements at the central peripheral, and average areas on Man-Whitney U test, with p-values of 0.037, 0.009, and 0.021, respectively.
Conclusion:
MRI with ADCs for preoperative pediatric tumor evaluation may be useful for predicting tendency of tumor grading and surgical planning.
Insights
Apparent diffusion coefficients (ADCs) measured using MRI can help differentiate pediatric low-grade from high-grade brain tumors. Higher ADC values indicate lower-grade tumors, aiding in surgical planning.
Area of Science:
- Neuroimaging
- Pediatric Oncology
- Radiology
Background:
- Magnetic Resonance Imaging (MRI) offers high sensitivity for brain tumor detection but struggles with accurate grading and histology.
- Diffusion-weighted imaging (DWI) and apparent diffusion coefficients (ADCs) provide insights into tumor cellularity, which correlates with tumor grade.
Purpose of the Study:
- To evaluate the efficacy of ADCs in distinguishing between low-grade and high-grade pediatric brain tumors.
- To assess the correlation between ADC values and tumor grade in pediatric brain tumors.
Main Methods:
- Retrospective review of preoperative MRI, DWI, and ADC images from pediatric patients with confirmed brain tumors.
- Manual placement of regions of interest in the center and periphery of solid tumor components.
- Calculation of ADC values at specific "b" values (0 and 1000 sec/mm²).
Main Results:
- ADC values were analyzed in 15 pediatric patients (7 low-grade, 8 high-grade).
- Significantly higher ADC values were observed in low-grade tumors compared to high-grade tumors.
- Statistical significance (p-values: 0.037, 0.009, 0.021) was found for central, peripheral, and average ADC measurements.
Conclusions:
- MRI utilizing ADCs shows promise for preoperative assessment of pediatric brain tumors.
- ADC measurements can aid in predicting tumor grade and optimizing surgical planning for pediatric brain tumors.
