Applicability of apparent diffusion coefficient ratios in preoperative diagnosis of common pediatric cerebellar tumors across two institutions View Full Text


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Article Info

DATE

2014-09

AUTHORS

Korgün Koral, Raphael Alford, Nabila Choudhury, Mahmud Mossa-Basha, Lynn Gargan, Barjor Gimi, Ang Gao, Song Zhang, Daniel C. Bowers, Kadriye M. Koral, Izlem Izbudak

ABSTRACT

INTRODUCTION: The purpose of our study was to test the accuracy and applicability of decision rules utilizing apparent diffusion coefficient (ADC) ratios on accurate preoperative diagnosis of common pediatric cerebellar tumors across two institutions. METHODS: In this HIPAA-compliant, IRB-approved study, performed at two institutions, 140 pediatric cerebellar tumors were included. Two separate reviewers placed regions of interest on the solid components of 140 tumors (98 at site A and 42 at site B) and normal brain on the ADC maps. The third reviewer who was blinded to the histopathological diagnoses made the same measurements on 140 patients to validate the data. Tumor to normal brain ADC ratios were calculated. Receiver operator curve (ROC) analysis was performed to generate thresholds to discriminate tumors. Utility of decision rules based on these thresholds was tested. RESULTS: While ADC values of medulloblastomas were different between the sites, there was no difference among the ADC ratios of medulloblastomas, pilocytic astrocytomas, ependymomas, and atypical teratoid rhabdoid tumors between the sites. ADC ratio of ≥1.8 correctly discriminated pilocytic astrocytomas from ependymomas with a sensitivity of 0.83 and a specificity of 0.78. ADC ratio of <1.2 correctly discriminated ependymomas from embryonal tumors with a sensitivity of 0.87 and a specificity of 0.83. The proposed decision rules correctly discriminated 120 of the 140 tumors (85.71%). Age ≥2 years criterion correctly sorted medulloblastomas in 84.48% of patients and age <2 years correctly distinguished atypical teratoid rhabdoid tumors in 90.00% of patients with embryonal tumors. CONCLUSIONS: Decision rules based on ADC ratios are applicable across two institutions in the accurate preoperative diagnosis of common pediatric cerebellar tumors. More... »

PAGES

781-788

References to SciGraph publications

  • 2008-05. CT and MR imaging in atypical teratoid/rhabdoid tumors of the central nervous system in NEURORADIOLOGY
  • 2008. Pilocytic Astrocytoma in ENCYCLOPEDIA OF DIAGNOSTIC IMAGING
  • 2008. Ependymoma in ENCYCLOPEDIA OF DIAGNOSTIC IMAGING
  • 2012-04. Molecular subgroups of medulloblastoma: the current consensus in ACTA NEUROPATHOLOGICA
  • 2011-06. Magnetic resonance imaging spectrum of medulloblastoma in NEURORADIOLOGY
  • 2013-08. MRI features of atypical teratoid/rhabdoid tumors in children in PEDIATRIC RADIOLOGY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00234-014-1398-z

    DOI

    http://dx.doi.org/10.1007/s00234-014-1398-z

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1006168497

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/24974083


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    46 schema:description INTRODUCTION: The purpose of our study was to test the accuracy and applicability of decision rules utilizing apparent diffusion coefficient (ADC) ratios on accurate preoperative diagnosis of common pediatric cerebellar tumors across two institutions. METHODS: In this HIPAA-compliant, IRB-approved study, performed at two institutions, 140 pediatric cerebellar tumors were included. Two separate reviewers placed regions of interest on the solid components of 140 tumors (98 at site A and 42 at site B) and normal brain on the ADC maps. The third reviewer who was blinded to the histopathological diagnoses made the same measurements on 140 patients to validate the data. Tumor to normal brain ADC ratios were calculated. Receiver operator curve (ROC) analysis was performed to generate thresholds to discriminate tumors. Utility of decision rules based on these thresholds was tested. RESULTS: While ADC values of medulloblastomas were different between the sites, there was no difference among the ADC ratios of medulloblastomas, pilocytic astrocytomas, ependymomas, and atypical teratoid rhabdoid tumors between the sites. ADC ratio of ≥1.8 correctly discriminated pilocytic astrocytomas from ependymomas with a sensitivity of 0.83 and a specificity of 0.78. ADC ratio of <1.2 correctly discriminated ependymomas from embryonal tumors with a sensitivity of 0.87 and a specificity of 0.83. The proposed decision rules correctly discriminated 120 of the 140 tumors (85.71%). Age ≥2 years criterion correctly sorted medulloblastomas in 84.48% of patients and age <2 years correctly distinguished atypical teratoid rhabdoid tumors in 90.00% of patients with embryonal tumors. CONCLUSIONS: Decision rules based on ADC ratios are applicable across two institutions in the accurate preoperative diagnosis of common pediatric cerebellar tumors.
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