Value and Limitations of Diffusion-Weighted Imaging in Grading and Diagnosis of Pediatric Posterior Fossa Tumors

DWI reportedly accurately differentiates pediatric posterior fossa tumors, but anecdotal experience suggests limitations. In 3 years, medulloblastoma and JPA were differentiated by DWI alone in 23/26 cases (88%). Ependymoma (n = 5) could not be reliably differentiated from medulloblastoma or JPA. A...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2010-10, Vol.31 (9), p.1613-1616
Main Authors: JAREMKO, J. L, JANS, L. B. O, COLEMAN, L. T, DITCHFIELD, M. R
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Brain - pathology
Child
Child, Preschool
Diffusion Magnetic Resonance Imaging - methods
Female
Fundamental and applied biological sciences. Psychology
Humans
Infant
Infant, Newborn
Infratentorial Neoplasms - pathology
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Nervous system
Pediatrics
Perception
Psychology. Psychoanalysis. Psychiatry
Psychology. Psychophysiology
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Reproducibility of Results
Sensitivity and Specificity
Vision
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Summary:DWI reportedly accurately differentiates pediatric posterior fossa tumors, but anecdotal experience suggests limitations. In 3 years, medulloblastoma and JPA were differentiated by DWI alone in 23/26 cases (88%). Ependymoma (n = 5) could not be reliably differentiated from medulloblastoma or JPA. A trend toward increased diffusion restriction in higher grade tumors (1/14 grade I, 7%; 9/12 grade IV, 75%) had too much overlap to predict the grade of individual cases. The overlap in ADC between tumor types appeared partly due to technical factors (in small, heterogeneous, calcific, or hemorrhagic tumors) but also likely reflected true histologic variability, given that our 3 overlap cases included a desmoplastic medulloblastoma, an anaplastic ependymoma, and a JPA with restricted diffusion in its nodule. Simple structural features (macrocystic tumor, location off midline) aided in distinguishing JPA from the other tumors in these cases.
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A2155