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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 27:1362-1369, June-July 2006
© 2006 American Society of Neuroradiology

PEDIATRICS

Apparent Diffusion Coefficients for Differentiation of Cerebellar Tumors in Children

Z. Rumboldt^a, D.L.A. Camacho^c, D. Lake^a, C.T. Welsh^b and M. Castillo^c

^a Departments of Radiology, Medical University of South Carolina, Charleston, SC
^b Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC
^c Department of Radiology, University of North Carolina, Chapel Hill, NC

Address correspondence to Zoran Rumboldt, MD, Department of Radiology, Medical University of South Carolina, 169 Ashley Ave, P.O. Box 250322, Charleston, SC 29425

BACKGROUND AND PURPOSE: Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps provide information at MR imaging that may reflect cell attenuation and integrity. We hypothesized that cerebellar tumors in children can be differentiated by their ADC values.

METHODS: Brain MR imaging studies that included ADC maps were retrospectively reviewed in 32 patients with histologically proved cerebellar neoplasm. There were 17 juvenile pilocytic astrocytomas (JPA), 8 medulloblastomas, 5 ependymomas, and 2 rhabdoid (atypical teratoid/rhabdoid tumor [AT/RT]) tumors. Absolute ADC values of contrast-enhancing solid tumor regions and ADC ratios (ADC of solid tumor to ADC of normal-appearing white matter) were compared with the histologic diagnosis. ADC values and ratios of JPAs, medulloblastomas, and ependymomas were compared by using a 2-tailed t test and one-way analysis of variance (ANOVA).

RESULTS: ADC values were significantly higher in pilocytic astrocytomas (1.65 ± 0.27) (mean ± SD) than in ependymomas (1.10 ± 0.11) (P = .0003) and medulloblastomas (0.66 ± 0.15) (P < .0001). Ependymomas demonstrated significantly higher ADC values than medulloblastomas (P = .0005). The observed differences were statistically significant on ANOVA (P < .001). ADC ratios were also significantly different among these 3 tumor types. AT/RT ADC values were similar to medulloblastoma. The range of ADC values and ratios within JPAs and ependymomas did not overlap with that of medulloblastomas.

CONCLUSION: Assessment of ADC values of enhancing solid tumor is a simple and reliable technique for preoperative differentiation of cerebellar tumors in pediatric patients. Our cutoff values of >1.4 x 10³ mm²/s for JPA and <0.9 x 10³ mm²/s for medulloblastoma were 100% specific.

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