Reliability of Imaging-Based Diagnosis of Lateral Ventricular Masses in Children

Sanjeev Kumar Pandey1, Sunithi Elizabeth Mani2, Sniya Valsa Sudhakar2

  • 1Department of Neurological Sciences, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.

World Neurosurgery
|January 21, 2019
PubMed

Insights

Radiologists accurately diagnosed benign pediatric lateral ventricular tumors but struggled with malignant ones. Interobserver variability was noted, highlighting challenges in imaging diagnosis for these rare pediatric brain tumors.

Area of Science:

  • Pediatric Radiology
  • Neuroradiology
  • Pediatric Neuro-oncology

Background:

  • Lateral ventricular masses in children represent a diverse group of pathologies.
  • Accurate radiologic diagnosis is crucial for guiding treatment and prognosis in pediatric patients.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of radiologic imaging for lateral ventricular masses in children.
  • To identify specific tumor types that are challenging to diagnose pre-operatively.

Main Methods:

  • Retrospective analysis of 43 pediatric patients (8 months to 20 years) with lateral ventricular masses.
  • Review of Magnetic Resonance Imaging (MRI) and contrast-enhanced Computed Tomography (CT) scans by three blinded radiologists.
  • Calculation of inter-radiologist agreement using the Fleiss κ statistic.

Main Results:

  • The study identified common pathologies including subependymal giant cell astrocytoma (SEGA), low-grade astrocytoma, and choroid plexus papilloma.
  • Radiologic diagnosis achieved an overall accuracy of 94.2%, with high accuracy for benign tumors (e.g., SEGA, low-grade gliomas).
  • Malignant tumors (e.g., high-grade gliomas, choroid plexus carcinomas) and cavernous angiomas were difficult to diagnose accurately, and inter-radiologist agreement was only fair (κ = 0.24).

Conclusions:

  • The radiologic diagnosis of pediatric lateral ventricular masses is accurate for benign entities but challenging for malignant neoplasms.
  • Significant interobserver variability exists in the interpretation of these imaging studies.
  • Further refinement of imaging criteria and potentially advanced techniques may improve diagnostic accuracy for difficult-to-diagnose pediatric brain tumors.
Abstract

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