Diffusion weighted imaging in differentiating malignant and benign neuroblastic tumors

Area of Science:

• Radiology
• Pediatric Oncology
• Medical Imaging

Background:

• Neuroblastic tumors encompass a spectrum of pediatric malignancies.
• Accurate differentiation is crucial for appropriate treatment strategies.
• Diffusion weighted imaging (DWI) offers insights into tissue microstructure.

Purpose of the Study:

• To evaluate the utility of apparent diffusion coefficient (ADC) values in distinguishing between neuroblastoma, ganglioneuroblastoma, and ganglioneuroma.
• To determine if ADC can serve as a quantitative marker for malignancy in neuroblastic tumors.

Main Methods:

• Retrospective analysis of DWI from 24 pediatric patients with histopathologically confirmed neuroblastic tumors.
• Calculation of ADC maps using freehand regions of interest on PACS.
• Inclusion of neuroblastoma (n=15), ganglioneuroblastoma (n=5), and ganglioneuroma (n=4) cases.

Main Results:

• A significant decrease in ADC values was observed in neuroblastomas (0.869 ± 0.179 × 10⁻³ mm²/s) compared to ganglioneuroblastomas (0.97 ± 0.203 × 10⁻³ mm²/s) and ganglioneuromas (1.147 ± 0.299 × 10⁻³ mm²/s) (p=0.026).
• No significant difference in ADC values was found between ganglioneuroblastoma and ganglioneuroma (p=0.16).
• ADC demonstrated a sensitivity of 74% and specificity of 67% for detecting neuroblastomas with a cut-off value of 0.93 × 10⁻³ mm²/s.

Conclusions:

• ADC values show potential in discriminating malignant neuroblastoma from benign ganglioneuroma and ganglioneuroblastoma.
• A suggested cut-off ADC value can aid in differentiating these tumor types.
• ADC is proposed as an objective, quantitative tool for distinguishing malignant from benign neuroblastic tumors.