Contributional role of susceptibility-weighted imaging and apparent diffusion coefficient in pediatric brain tumor grading

Abstract

Background Central nervous system neoplasms are a primary cause of mortality and one of the most frequent solid tumors in children. Magnetic resonance imaging (MRI) plays a key role in the diagnosis and treatment response of pediatric brain tumors as well as providing us with functional information regarding cellularity, metabolism, and neoangiogenesis. This study aimed to evaluate the contributional role of susceptibility-weighted imaging (SWI) and diffusion weight imaging (DWI) in pediatric brain tumor grading by assessing the intratumoral susceptibility signals (ITSS), apparent diffusion coefficient (ADC), and relative ADC (rADC). Results A significant correlation was noted between the (ITSS) score and the brain tumor grade (P < 0.001) with a descending trend in the low-grade tumor (ITSS score 0 = 14/29, score 1 = 11/29, and score 2 = 4/29) and an ascending trend in the high-grade tumor (ITSS score 0 = 4/41, score 1 = 9/41 and score 2 = 22/41). No embryonal tumor showed an ITSS score of 0. Apparent diffusion coefficient sensitivity and specificity were 82.9% and 82.8%, respectively, while rADC sensitivity and specificity were 91.4% and 86.2%, respectively. For high-grade tumors, the ITSS score 2 had a significant positive prediction (P = 0.009) and the rADC value had a significant negative prediction (P = 0.031). Conclusions Susceptibility-weighted imaging ITSS score, ADC, and rADC have a promising role in preoperative pediatric brain tumor grading and should be considered as complementary sequences to routine MRI studies.