Diffusion-Weighted MRI: Distinction of Skull Base Chordoma from Chondrosarcoma

Abstract

BACKGROUND AND PURPOSE:Chordoma and chondrosarcoma of the skull base are rare tumors with overlapping presentations and anatomic imaging features but different prognoses. We hypothesized that these tumors might be distinguished by using diffusionweighted MR imaging.

Chordoid Meningioma: Differentiating a Rare World Health Organization Grade II Tumor from Other Meningioma Histologic Subtypes Using MRI

“…The presence of the mucoid stroma results in relatively free extracellular water motion, which is in keeping with multiple studies in which elevated ADC values were found in other tumors that are composed of myxoid stroma, such as chordomas, chondrosarcomas, and myxoid soft-tissue tumors. 18,19 In addition, a component of cell vacuolization resulting in a decreased nucleus-to-cytoplasm ratio likely contributes further to an increase in the diffusivity of water in these tumors. Our findings differ from previously published data which reveal that atypical WHO grade II/III meningiomas show decreased ADC values consistent with a greater degree of restricted diffusion compared with that of typical WHO grade I meningioma subtypes.…”

Role of the Apparent Diffusion Coefficient as a Predictor of Tumor Progression in Patients with Chordoma

“…2 DWI could potentially be used to distinguish chordoma from chondrosarcoma because the ADC values for chordoma are lower than those for chondrosarcoma. 3,4 Moreover, the ADC values are lower in aggressive chordomas than in classic chordomas, suggesting that ADC may be useful for classifying chordomas into subcategories according to aggressiveness. 4 Hanna et al 5 suggested that a low T2 component in chordoma represented aggressive chordoma.…”

“…3,4 Moreover, the ADC values are lower in aggressive chordomas than in classic chordomas, suggesting that ADC may be useful for classifying chordomas into subcategories according to aggressiveness. 4 Hanna et al 5 suggested that a low T2 component in chordoma represented aggressive chordoma. Classic and chondroid chordomas contain stromal mucin and chondroid matrix, respectively, which produce an increased T2 signal and a higher ADC, whereas an aggressive tumor contains less stroma with high cellularity and a lower ADC.…”

“…Classic and chondroid chordomas contain stromal mucin and chondroid matrix, respectively, which produce an increased T2 signal and a higher ADC, whereas an aggressive tumor contains less stroma with high cellularity and a lower ADC. 4 However, there is sparse literature describing the relationship between the MR imaging signal characteristics of chordoma and prognosis. Surgical resection is the standard therapy for chordoma, though there have been recent advances in radiation therapy (RT).…”

Differentiation of Skull Base Chordomas from Chondrosarcomas by Diffusion-Weighted MRI

“…e read with great interest the recent article entitled "Diffusion-Weighted MRI: Distinction of Skull Base Chordoma from Chondrosarcoma" by Yeom et al 1 The authors showed, with a sample of 19 patients, that skull base chondrosarcomas could be differentiated from chordomas and from atypical chordomas by ADC values on diffusion-weighted MR imaging. This result represents a significant advance, because there are no other imaging approaches to reliably distinguish these central skull base tumors.…”