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Dynamic susceptibility contrast perfusion imaging in biopsy-proved adult medulloblastoma
Marianne Theillac1, David Meyronet2, Julien Savatovsky3
1Service de Radiologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Chemin du Grand-Revoyet, 69495 Pierre-Bénite, France.
Purpose:
Medulloblastoma (MB) is a high-grade rare brain tumor in adults, with heterogeneous imaging features and variable enhancing patterns. Diffusion and spectroscopy multimodal imaging have already been described in adult MB, yet perfusion has not been explored. This study aimed to evaluate vascularity in adult classic and desmoplastic MB, using perfusion-weighted dynamic susceptibility contrast (DSC) MRI and histopathology.
Methods:
Six histologically proved MB patients were classified as classic (n=3) and desmoplastic (n=3). DSC perfusion MRI was performed in three centers and retrospectively evaluated. Postprocessing included automatic arterial input function, motion and contrast leakage correction. Region of interest (ROI) delineation was performed on three perfusion slices to obtain a total of three cerebral blood volume ratios (rCBV) that were averaged to serve as the main rCBV. Permeability was evaluated on K2 maps.
Results:
Low rCBVs were observed in all cases (mean rCBV=1.19±0.39). rCBV values were lower than 2 for classic MB and lower than 1 for desmoplastic MB. All cases showed an increase of permeability on K2 maps.
Conclusions:
Our preliminary results suggest that MB exhibits rCBV values close to 1 and increased permeability on DSC perfusion imaging, especially in desmoplastic cases, which could be explained by fibrous matrix. This type of perfusion pattern contrasts with those given by other enhancing subtentorial tumors such as metastasis, high-grade gliomas or hemangioblastomas.
Insights
This study shows that adult medulloblastoma (MB) has low cerebral blood volume (rCBV) and increased permeability on dynamic susceptibility contrast (DSC) MRI. These perfusion patterns may help differentiate MB from other brain tumors.
Area of Science:
- Neuro-oncology
- Radiology
- Medical Imaging
Background:
- Medulloblastoma (MB) is a rare, high-grade adult brain tumor with diverse imaging characteristics.
- While diffusion and spectroscopy MRI are studied in adult MB, perfusion imaging remains underexplored.
- Understanding MB vascularity is crucial for diagnosis and treatment planning.
Purpose of the Study:
- To evaluate vascularity in adult classic and desmoplastic medulloblastoma (MB).
- To utilize dynamic susceptibility contrast (DSC) perfusion MRI and histopathology for assessment.
- To characterize perfusion patterns and compare them with other subtentorial tumors.
Main Methods:
- Retrospective analysis of DSC perfusion MRI data from six adult MB patients (3 classic, 3 desmoplastic) across three centers.
- Postprocessing included motion and contrast leakage correction.
- Quantification of cerebral blood volume ratios (rCBV) and K2 permeability maps.
Main Results:
- All MB cases demonstrated low rCBV values (mean 1.19±0.39).
- rCBV values were below 2 for classic MB and below 1 for desmoplastic MB.
- Increased permeability was observed in all cases on K2 maps.
Conclusions:
- Adult MB exhibits low rCBV and increased permeability on DSC perfusion imaging.
- Desmoplastic MB showed particularly low rCBV, potentially due to its fibrous matrix.
- This distinct perfusion profile may aid in differentiating MB from other subtentorial tumors like metastases or gliomas.
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