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Published on: July 5, 2021
Differentiating between adult intracranial medulloblastoma and ependymoma using MRI
1Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China.
Aim:
To investigate the value of routine magnetic resonance imaging (MRI) examination combined with diffusion-weighted imaging (DWI) in the differential diagnosis of adult intracranial medulloblastomas and ependymomas.
Materials And Methods:
MRI images of 18 medulloblastomas and 18 ependymomas in adult patients were analysed retrospectively, and the differences in MRI features of lesions and apparent diffusion coefficient (ADC) of solid lesions between the two groups were recorded. Independent sample t-tests and χ2 tests were used to analyse the differences in MRI signs and maximum ADC (ADCmax), minimum ADC (ADCmin), and mean ADC (ADCmean) values between the two groups. The receiver operating characteristic (ROC) curve was used to determine the differential diagnostic efficacy and optimal threshold for each ADC value.
Results:
Age, tumour location, and tumour enhancement were significantly different between adult medulloblastoma and ependymoma (p<0.05). The ADCmax (0.69 ± 0.11 versus 1.04 ± 0.20 × 10-3 mm2/s, p<0.001), ADCmin (0.57 ± 0.12 versus 0.96 ± 0.21 × 10-3 mm2/s, p<0.001), and ADCmean (0.62 ± 0.11 versus 1.00 ± 0.20 × 10-3 mm2/s, p<0.001) values were significantly lower in adult medulloblastoma than in ependymoma. The areas under the ROC curves of ADCmax, ADCmin, and ADCmean were 0.951, 0.957, and 0.966, respectively. The optimal ADCmean threshold was 0.75 × 10-3 mm2/s, with a sensitivity of 88.9% and a specificity of 88.9%.
Conclusion:
Routine MRI examination combined with DWI helps differentiate between intracranial infratentorial medulloblastoma and ependymoma in adults.
Insights
Routine magnetic resonance imaging (MRI) combined with diffusion-weighted imaging (DWI) effectively differentiates adult intracranial medulloblastomas from ependymomas. Lower apparent diffusion coefficient (ADC) values indicate medulloblastoma, aiding in diagnosis.
Area of Science:
- Neuroradiology
- Oncology
- Medical Imaging
Background:
- Distinguishing between adult intracranial medulloblastomas and ependymomas can be challenging using conventional imaging techniques.
- Magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) offers advanced insights into tissue microstructure.
- Apparent diffusion coefficient (ADC) values provide quantitative information about water molecule diffusion within tumors.
Purpose of the Study:
- To evaluate the diagnostic utility of routine MRI combined with DWI for the differential diagnosis of adult intracranial medulloblastomas and ependymomas.
- To compare MRI features and ADC values between medulloblastomas and ependymomas in adult patients.
Main Methods:
- Retrospective analysis of MRI scans from 18 adult medulloblastomas and 18 adult ependymomas.
- Comparison of lesion MRI characteristics and apparent diffusion coefficient (ADC) values (ADCmax, ADCmin, ADCmean) between the two groups.
- Statistical analysis using independent sample t-tests and chi-squared tests, with receiver operating characteristic (ROC) curve analysis for diagnostic efficacy.
Main Results:
- Significant differences were observed in age, tumor location, and tumor enhancement between medulloblastomas and ependymomas (p<0.05).
- Medulloblastomas exhibited significantly lower ADCmax, ADCmin, and ADCmean values compared to ependymomas (p<0.001).
- ROC curve analysis demonstrated high diagnostic performance, with the optimal ADCmean threshold of 0.75 × 10⁻³ mm²/s achieving 88.9% sensitivity and 88.9% specificity.
Conclusions:
- Routine MRI combined with DWI is a valuable tool for differentiating adult intracranial infratentorial medulloblastomas from ependymomas.
- Lower ADC values are indicative of medulloblastoma, facilitating accurate differential diagnosis.
- The quantitative ADC measurements provide reliable parameters for distinguishing these two tumor types.
