Magnetic resonance spectroscopy in posterior fossa tumours: the tumour spectroscopic signature may improve discrimination in adults among haemangioblastoma, ependymal tumours, medulloblastoma, and metastasis

Mora, Paloma; Pons, Albert; Cos, Mònica; Camins, Àngels; Muntané, Amadeo; Aguilera, Carles; Arús, Carles; Majós, Carles

doi:10.1007/s00330-018-5879-z

Cited by 15 publications

(12 citation statements)

References 26 publications

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“…In this study, Cho and Cho/NAA levels were significantly lower in ependymomas compared to medulloblastoma. Thus, our findings are consistent with previous studies [ 8 – 13 ].…”

Section: Discussionsupporting

confidence: 94%

“…The studied metabolites included fatty acids, Cho, leucine, NAA, isoleucine, valine, γ-aminobutyric acid, acetate, glutamate, glutamine, glycine, myoinositol, creatine, serine, phenylalanine, and taurine [ 12 ]. In a previous study with MRS with a TE of 30 ms or 136 ms to distinguish between medulloblastoma, ependymoma, haemangioblastoma, and brain metastases, it was also revealed that Cho/NAA ratio helped to distinguish between medulloblastoma and ependymoma with an accuracy of 92% [ 13 ]. In this study, Cho and Cho/NAA levels were significantly lower in ependymomas compared to medulloblastoma.…”

Section: Discussionmentioning

confidence: 99%

“…Prior knowledge of the concentration of active substances in a tumour can provide valuable information for differential diagnosis, treatment strategy, and prognosis. Several previous studies have used MRS to assess and distinguishing brain tumour types in both adults and children [ 8 , 10 – 13 ]. Therefore, in this clinical study, we investigated the impact of MRS parameters on differentiating between paediatric medulloblastoma and ependymoma.…”

Section: Introductionmentioning

confidence: 99%

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The impact of magnetic resonance imaging spectroscopy parameters on differentiating between paediatric medulloblastoma and ependymoma

Duc

2021

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Introduction The distinction of medulloblastomas and ependymomas plays an important role in the care plans and prognosis of children. We aimed to investigate the role of magnetic resonance spectroscopy (MRS) in the differentiation between medulloblastomas and ependymomas in children. Materials and methods The institutional review board approved this prospective study. The brain magnetic resonance imaging protocol including axial multivoxel spectroscopy with a TE of 144 ms was assessed in 49 patients, who were divided into 2 groups: 40 patients with medulloblastomas and 9 patients with ependymomas. Receiver operating characteristic (ROC) curve analysis and the Youden index were utilized to determine the best cut-off, sensitivity, specificity, and area under the curve (AUC) values of the independent spectroscopy parameters. Results The choline level (Cho) and the choline/creatine (Cho/Cr) and choline/N-acetyl aspartate (Cho/NAA) ratios of medulloblastomas were significantly higher than those of ependymomas ( p < 0.05). A Cho/NAA cut-off value of 1.24 to predict the diagnosis of medulloblastoma yielded the highest AUC and sensitivity of 80.3% and 97.5%, respectively, while a Cho cut-off value of 4.64 produced the highest specificity value of 88.9%. Conclusions Our findings suggest that Cho and Cho/NAA derived from MRS could serve as differential factors between paediatric medulloblastomas and ependymomas. Among those, a Cho/NAA cut-off value of 1.24 to predict the diagnosis of medulloblastoma generated the highest accuracy.

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“…In this study, Cho and Cho/NAA levels were significantly lower in ependymomas compared to medulloblastoma. Thus, our findings are consistent with previous studies [ 8 – 13 ].…”

Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The impact of magnetic resonance imaging spectroscopy parameters on differentiating between paediatric medulloblastoma and ependymoma

Duc

2021

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“…Prominent Lip, low creatine (Cr), absence of N-acetylaspartate (NAA), and increased choline (Cho) in HBs have been reported. 8 , 16 , 17 The presence of Lip/Lac may be associated with lipid droplets contained in the stromal cells of HBs. 2 , 8 Both Cases 2 and 3 showed increased Lip/Lac on MRS.…”

Section: Discussionmentioning

confidence: 99%

“… 6 , 7 However, they sometimes cannot be reliably distinguished from other tumors by conventional MRI, especially pilocytic astrocytomas (PAs) in adolescents 8 and metastatic brain tumors (Mets) in adults, 9 because of their similar imaging findings and locations. The application of advanced MRI techniques, including diffusion-weighted imaging (DWI), 9 – 12 dynamic susceptibility-weighted contrast-enhanced perfusion-weighted imaging (DSC-PWI), 8 , 9 , 11 , 13 – 15 and proton magnetic resonance (MR) spectroscopy (MRS), 8 , 16 , 17 has a better chance of assessing and distinguishing the functional and metabolic differences between HBs and other tumors. We present three cases of HB and review their findings on conventional and advanced MRI, including DWI, DSC-PWI, and MRS.…”

Section: Introductionmentioning

confidence: 99%

Advanced magnetic resonance imaging findings of cerebellar hemangioblastomas: A report of three cases and a literature review

Matsusue

Inoue

Tabuchi

et al. 2022

Acta Radiologica Open

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On conventional magnetic resonance imaging (MRI), hemangioblastomas typically appear as mural nodules with an adjacent surrounding cyst or a solid mass in the cerebellum. However, hemangioblastomas sometimes cannot be reliably distinguished using this imaging technique from other tumors, especially pilocytic astrocytomas and metastatic tumors, because of their similar imaging findings and locations. Herein, we report three cases of cerebellar hemangioblastomas and review their findings on conventional and advanced MRI, including diffusion-weighted imaging (DWI), dynamic susceptibility-weighted contrast-enhanced perfusion-weighted imaging (DSC-PWI), and magnetic resonance spectroscopy (MRS). Solid contrast-enhanced lesions of hemangioblastomas showed increased apparent diffusion coefficient values on DWI, increased relative cerebral blood volume ratio on DSC-PWI, and high lipid/lactate peak on MRS. Therefore, advanced MRI techniques can be helpful in understanding the pathological and metabolic changes of hemangioblastomas and may be useful for their characterization.

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A Convolutional Neural Network Model for Distinguishing Hemangioblastomas From Other Cerebellar‐and‐Brainstem Tumors Using Contrast‐Enhanced MRI

Sheng,

Zhao,

Cheng

et al. 2024

Magnetic Resonance Imaging

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BackgroundHemangioblastoma (HB) is a highly vascularized tumor most commonly occurring in the posterior cranial fossa, requiring accurate preoperative diagnosis to avoid accidental intraoperative hemorrhage and even death.PurposeTo accurately distinguish HBs from other cerebellar‐and‐brainstem tumors using a convolutional neural network model based on a contrast‐enhanced brain MRI dataset.Study TypeRetrospective.PopulationFour hundred five patients (182 = HBs; 223 = other cerebellar‐and brainstem tumors): 305 cases for model training, and 100 for evaluation.Field Strength/Sequence3 T/contrast‐enhanced T1‐weighted imaging (T1WI + C).AssessmentA CNN‐based 2D classification network was trained by using sliced data along the z‐axis. To improve the performance of the network, we introduced demographic information, various data‐augmentation methods and an auxiliary task to segment tumor region. Then, this method was compared with the evaluations performed by experienced and intermediate‐level neuroradiologists, and the heatmap of deep feature, which indicates the contribution of each pixel to model prediction, was visualized by Grad‐CAM for analyzing the misclassified cases.Statistical TestsThe Pearson chi‐square test and an independent t‐test were used to test for distribution difference in age and sex. And the independent t‐test was exploited to evaluate the performance between experts and our proposed method. P value <0.05 was considered significant.ResultsThe trained network showed a higher accuracy for identifying HBs (accuracy = 0.902 ± 0.031, F1 = 0.891 ± 0.035, AUC = 0.926 ± 0.040) than experienced (accuracy = 0.887 ± 0.013, F1 = 0.868 ± 0.011, AUC = 0.881 ± 0.008) and intermediate‐level (accuracy = 0.827 ± 0.037, F1 = 0.768 ± 0.068, AUC = 0.810 ± 0.047) neuroradiologists. The recall values were 0.910 ± 0.050, 0.659 ± 0.084, and 0.828 ± 0.019 for the trained network, intermediate and experienced neuroradiologists, respectively. Additional ablation experiments verified the utility of the introduced demographic information, data augmentation, and the auxiliary‐segmentation task.Data ConclusionOur proposed method can successfully distinguish HBs from other cerebellar‐and‐brainstem tumors and showed diagnostic efficiency comparable to that of experienced neuroradiologists.Evidence Level3Technical EfficacyStage 2

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Magnetic resonance spectroscopy in posterior fossa tumours: the tumour spectroscopic signature may improve discrimination in adults among haemangioblastoma, ependymal tumours, medulloblastoma, and metastasis

Cited by 15 publications

References 26 publications

The impact of magnetic resonance imaging spectroscopy parameters on differentiating between paediatric medulloblastoma and ependymoma

The impact of magnetic resonance imaging spectroscopy parameters on differentiating between paediatric medulloblastoma and ependymoma

Advanced magnetic resonance imaging findings of cerebellar hemangioblastomas: A report of three cases and a literature review

A Convolutional Neural Network Model for Distinguishing Hemangioblastomas From Other Cerebellar‐and‐Brainstem Tumors Using Contrast‐Enhanced MRI

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