Advantages of high b-value diffusion-weighted imaging for preoperative differential diagnosis between embryonal and ependymal tumors at 3 T MRI

Takayasu, Takeshi; Yamasaki, Fumiyuki; Akiyama, Yuji; Ohtaki, Megu; Saito, Taiichi; Nosaka, Ryo; Takano, Motoki; Sakamoto, Kazuhiko; Kurisu, Kaoru

doi:10.1016/j.ejrad.2018.02.013

Cited by 8 publications

(11 citation statements)

References 28 publications

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“…A major goal of the present study was to assess potential associations between the genetic subtypes and immunohistochemical parameters of medulloblastoma using quantitative (ADC) MRI, as comparable literature data are sparse. Considering the whole study population ( n = 32), the calculated ADC mean within the solid tumor components was 586 (10 −6 mm 2 /s), which is in the range of data reported by other authors who did not explicitly investigate genetic subtypes 13,20,22 . Similar to the results of Perreault and colleagues, 12 difference of the ADC mean between genetic subtypes did not reach statistical significance, which was possibly caused by the low sample size of the WNT‐activated subgroup ( P = .080).…”

Section: Discussionsupporting

confidence: 73%

“…Considering the whole study population (n = 32), the calculated ADC mean within the solid tumor components was 586 (10 −6 mm 2 /s), which is in the range of data reported by other authors who did not explicitly investigate genetic subtypes. 13,20,22 Similar to the results of Perreault and colleagues, 12 difference of the ADC mean between genetic subtypes did not reach statistical significance, which was possibly caused by the low sample size of the WNT-activated subgroup (P = .080). However, the mean ADC value was lowest in this subgroup (480 [10 −6 mm 2 /s]); this finding is comparable to recently published data of Reddy and colleagues.…”

Section: Discussionsupporting

confidence: 68%

“…A neuroradiologist ( J.R.) with 4 years of experience in diagnostic neuroradiology who was blinded to neuropathological and clinical data performed ADC measurements in each presurgical MRI, using a dedicated picture archiving and communication system (syngo Imaging, Siemens Healthineers). In detail, ROIs with a size of 30-100 mm 2 were manually placed within the solid tumor components as previously described, 22,27 carefully avoiding inhomogeneous regions such as cysts or hemorrhage. To decrease the amount of discordant values, measurements were carried out thrice for each slice in each patient, yielding at least six to nine ROIs.…”

Section: Quantitative Adc Analysismentioning

confidence: 99%

“…This parameter is independent of the field strength as it refers to the mean diffusivity that is rotationally invariant, [16][17][18] and associated with tumor cell density. 19 Several studies illustrated that ADC calculation within the neoplasm is valuable for both differential diagnosis of posterior fossa tumors [20][21][22][23][24] and more accurate histopathological classification of medulloblastomas. 13 However, systematic ADC data specifically considering the genetic subtypes and immunohistochemical features of medulloblastoma are clearly underrepresented in the literature.…”

Section: Introductionmentioning

confidence: 99%

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Advanced MRI Findings in Medulloblastomas: Relationship to Genetic Subtypes, Histopathology, and Immunohistochemistry

Reis

Stahl

Zimmermann

et al. 2021

Journal of Neuroimaging

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BACKGROUND AND PURPOSE: For diagnosis of medulloblastoma, the updated World Health Organization classification now demands for genetic typing, defining more precisely the tumor biology, therapy, and prognosis. We investigated potential associations between magnetic resonance imaging (MRI) parameters including apparent diffusion coefficient (ADC) and neuropathologic features of medulloblastoma, focusing on genetic subtypes. METHODS: This study was a retrospective single-center analysis of 32 patients (eight females, median age = 9 years [range, 1-57], mean 12.6 ± 11.3) from 2012 to 2019. Genetic subtypes (wingless [WNT]; sonic hedgehog [SHH]; non-WNT/non-SHH), histopathology, immunohistochemistry (p53, Ki67), and the following MRI parameters were correlated: tumor volume, location (midline, pontocerebellar, and cerebellar hemisphere), edema, hydrocephalus, metastatic disease (presence/absence and each), contrast-enhancement (minor, moderate, and distinct), cysts (none, small, and large), hemorrhage (none, minor, and major), and ADC mean. The ADC mean was calculated using manually set regions of interest within the solid tumor. Statistics comprised univariate and multivariate testing. RESULTS: Out of 32 tumors, three tumors were WNT activated (9.4%), 13 (40.6%) SHH activated, and 16 (50.0%) non-WNT/non-SHH. Hemispherical location (n = 7/8, P = .003) and presence of edema (8/8; P < .001, specificity 100%, positive predictive value 100%) were significantly associated with SHH activation. The combined parameter "no edema + no metastatic disease + cysts" significantly discriminated WNT-activated from SHH-activated medulloblastoma (P = .036). ADC mean (10-6 mm 2 /s) was 484 for WNT-activated, 566 for SHH-activated, and 624 for non-WNT/non-SHH subtypes (P = .080). A significant negative correlation was found between ADC mean and Ki67 (r =-.364, P = .040). CONCLUSION: MRI analysis enabled noninvasive differentiation of SHH-activated medulloblastoma. ADC alone was not reliable for genetic characterization, but associated with tumor proliferation rate.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionsupporting

confidence: 68%

Section: Quantitative Adc Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Advanced MRI Findings in Medulloblastomas: Relationship to Genetic Subtypes, Histopathology, and Immunohistochemistry

Reis

Stahl

Zimmermann

et al. 2021

Journal of Neuroimaging

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“…Accordingly, in brain and body imaging, ultra-high b-values have shown promise in a clinical setting. Specifically, it has been suggested that diagnostic performance can be improved by using ultra-high b-values as compared to lower b-values [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Single shot zonal oblique multislice SE-EPI diffusion-weighted imaging with low to ultra-high b-values for the differentiation of benign and malignant vertebral spinal fractures

Sartoretti

Sartoretti–Schefer

Smoorenburg

et al. 2021

European Journal of Radiology Open

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Purpose To investigate the diagnostic yield of low to ultra-high b-values for the differentiation of benign from malignant vertebral fractures using a state-of-the-art single-shot zonal-oblique-multislice spin-echo echo-planar diffusion-weighted imaging sequence (SShot ZOOM SE-EPI DWI). Materials and Methods 66 patients (34 malignant, 32 benign) were examined on 1.5 T MR scanners. ADC maps were generated from b-values of 0,400; 0,1000 and 0,2000s/mm 2 . ROIs were placed into the fracture of interest on ADC maps and trace images and into adjacent normal vertebral bodies on trace images. The ADC of fractures and the Signal-Intensity-Ratio (SIR) of fractures relative to normal vertebral bodies on trace images were considered quantitative metrics. The appearance of the fracture of interest was graded qualitatively as iso-, hypo-, or hyperintense relative to normal vertebrae. Results ADC achieved an area under the curve (AUC) of 0.785/0.698/0.592 for b = 0,400/0,1000/0,2000s/mm 2 ADC maps respectively. SIR achieved an AUC of 0.841/0.919/0.917 for b = 400/1000/2000s/mm 2 trace images respectively. In qualitative analyses, only b = 2000s/mm 2 trace images were diagnostically valuable (sensitivity:1, specificity:0.794). Machine learning models incorporating all qualitative and quantitative metrics achieved an AUC of 0.95/0.98/0.98 for b-values of 400/1000/2000s/mm 2 respectively. The model incorporating only qualitative metrics from b = 2000s/mm 2 achieved an AUC of 0.97. Conclusion By using quantitative and qualitative metrics from SShot ZOOM SE-EPI DWI, benign and malignant vertebral fractures can be differentiated with high diagnostic accuracy. Importantly qualitative analysis of ultra-high b-value images may suffice for differentiation as well.

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Differentiating between adult intracranial medulloblastoma and ependymoma using MRI

Deng¹,

Xue²,

Liu³

et al. 2023

Clinical Radiology

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Advantages of high b-value diffusion-weighted imaging for preoperative differential diagnosis between embryonal and ependymal tumors at 3 T MRI

Cited by 8 publications

References 28 publications

Advanced MRI Findings in Medulloblastomas: Relationship to Genetic Subtypes, Histopathology, and Immunohistochemistry

Advanced MRI Findings in Medulloblastomas: Relationship to Genetic Subtypes, Histopathology, and Immunohistochemistry

Single shot zonal oblique multislice SE-EPI diffusion-weighted imaging with low to ultra-high b-values for the differentiation of benign and malignant vertebral spinal fractures

Differentiating between adult intracranial medulloblastoma and ependymoma using MRI

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Advantages of high b-value diffusion-weighted imaging for preoperative differential diagnosis between embryonal and ependymal tumors at 3 T MRI

Cited by 8 publications

References 28 publications

Advanced MRI Findings in Medulloblastomas: Relationship to Genetic Subtypes, Histopathology, and Immunohistochemistry

Advanced MRI Findings in Medulloblastomas: Relationship to Genetic Subtypes, Histopathology, and Immunohistochemistry

Single shot zonal oblique multislice SE-EPI diffusion-weighted imaging with low to ultra-high b-values for the differentiation of benign and malignant vertebral spinal fractures

Differentiating between adult intracranial medulloblastoma and ependymoma using MRI

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Advantages of high b-value diffusion-weighted imaging for preoperative differential diagnosis between embryonal and ependymal tumors at 3 T MRI