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Published on: June 7, 2020
Conventional magnetic resonance imaging in the differentiation between high and low-grade brain tumours in paediatric
Luciana Porto1, Alina Jurcoane1, Dirk Schwabe2
1Department of Neuroradiology of the Johann Wolfgang Goethe University, Frankfurt/Main, Germany.
Objective:
It has been described that hyperintensity in diffusion-weighted imaging (DWI) correlates with high-grade tumours, and high signal-intensity in T2-weighted (T2w) images identifies low-grade tumours. We aimed to investigate the potential of routine conventional MRI sequences, such as DWI and T2-w, to pre-operatively distinguish between low-grade and high-grade brain tumours in paediatric patients.
Material And Methods:
Two raters, blinded to the histological diagnosis, rated the aspect and signal intensity of MR images (T2w and DWI) from 37 children with newly diagnosed brain tumours. Histological diagnoses included 18 low-grade and 19 high-grade brain tumours.
Results:
The inter-rater agreement was 81-95%. High-grade tumours were never hypointense on DWI and low-grade tumours were usually hyperintense on T2w. Specificity was 100% for low-grade tumours and 90% for high-grade tumours. About 95% of the high-grade tumours and about 70% of the low-grade tumours were correctly diagnosed.
Conclusion:
The combination of general morphological aspect of the tumours and signals on T2-w and DWI yield a high accuracy of pre-operative differentiation between low-grade and high-grade paediatric tumours.
Insights
Routine MRI sequences, including diffusion-weighted imaging (DWI) and T2-weighted (T2w) images, can accurately differentiate pediatric low-grade from high-grade brain tumors before surgery. This non-invasive approach aids in diagnosis and treatment planning.
Area of Science:
- Pediatric neuro-oncology
- Neuroradiology
- Medical imaging analysis
Background:
- Conventional MRI sequences like DWI and T2w are crucial for brain tumor assessment.
- Previous studies suggest DWI hyperintensity indicates high-grade tumors, while T2w hyperintensity suggests low-grade tumors.
Purpose of the Study:
- To evaluate the efficacy of routine MRI sequences (DWI and T2w) in pre-operative differentiation of pediatric low-grade versus high-grade brain tumors.
Main Methods:
- Two blinded raters assessed T2w and DWI images from 37 pediatric patients with newly diagnosed brain tumors.
- Histological diagnoses confirmed 18 low-grade and 19 high-grade tumors.
Main Results:
- High-grade tumors were consistently hyperintense on DWI; low-grade tumors were typically hyperintense on T2w.
- Specificity reached 100% for low-grade and 90% for high-grade tumors.
- Overall diagnostic accuracy was approximately 95% for high-grade and 70% for low-grade tumors.
Conclusions:
- The combined analysis of tumor morphology and T2w/DWI signals provides high accuracy for pre-operative grading of pediatric brain tumors.
- Routine MRI sequences offer a reliable method for distinguishing tumor grades in children.
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