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Diffusion-weighted imaging in pediatric extracranial germ cell tumors
Carlos Eduardo Bezerra Cavalcante1,2,3, Fernanda Magalhães Pereira Souza1,2,3, Gisele Eiras Martins2,3
1Department of Pediatric Radiology, Children's Cancer Hospital, Hospital de Amor, Barretos, São Paulo, Brazil.
Plos One
|November 30, 2023
Summary
Diffusion-weighted imaging (DWI) can help differentiate pediatric pure teratomas from malignant germ cell tumors (GCTs). Mean ADC values also show promise in monitoring treatment response in malignant GCTs.
Area of Science:
- Radiology
- Pediatric Oncology
- Medical Imaging
Background:
- Germ cell tumors (GCTs) are rare and diverse pediatric neoplasms.
- Diffusion-weighted imaging (DWI) may indicate tumor cellularity and treatment response.
- The utility of DWI in pediatric GCTs requires further investigation.
Purpose of the Study:
- To evaluate DWI features in pediatric extracranial GCTs.
- To assess the potential of DWI in differentiating GCT subtypes.
- To explore DWI's role in monitoring treatment response.
Main Methods:
- Retrospective analysis of 43 pediatric GCT patients' MRI scans (T1, T2, DWI, ADC).
- Region of interest (ROI) selection focused on areas of restricted diffusion and low ADC values.
- Mean ADC (mADC) values were calculated and analyzed using ROC analysis.
Main Results:
- Pure teratomas showed significantly higher mADC values than other GCT histologies (p<0.001).
- A cutoff mADC of 1,179.00 x 10-3 mm2/s differentiated pure teratomas with 95.8% sensitivity and 92.9% specificity.
- Malignant GCTs exhibited increased mADC during treatment compared to diagnosis (p<0.001).
Conclusions:
- Mean ADC assessment can distinguish pure teratomas from malignant GCT histologies at diagnosis.
- DWI shows potential as a complementary tool for monitoring treatment response in malignant GCTs.
