Article Figures & Data
Figures
- Fig 1.
A 4-month-old girl with poorly differentiated carcinoma of the left cerebral hemisphere. A, Representative axial image from ADC map demonstrates manual tracing with general exclusion of large areas of blood products represented by susceptibility artifacts. B, Histogram of all included ADC values of the tumor from the semi-automated method.
- Fig 2.
An 11-month-old boy with atypical teratoid/rhabdoid tumor. A, Axial T2-weighted image demonstrates a heterogeneous mass in the right frontal temporal lobe with peripheral cystic change, little peritumoral white matter T2 prolongation, and B, heterogeneous enhancement on postcontrast axial 3D T1-weighted image. C, Representative ADC manual region of interest measurement with a small region of interest within the lowest signal portion of the tumor and larger region of interest measuring the contralateral normal thalamus. D, Semi-automated histogram for the ADC values of the entire tumor.
- Fig 3.
A 12-month-old child with desmoplastic infantile ganglioglioma. A, Axial T2-weighted image demonstrates a heterogeneous mass in the left frontal lobe with cystic change, adjacent T2 prolongation, midline shift, and contralateral ventricular entrapment. B, Axial 3D T1-weighted image demonstrates a peripheral enhancing solid component along the dural margin. C, ADC map with representative manual region of interest evaluation within the solid components of the tumor and contralateral white matter. D, Semi-automated histogram for the ADC values of the entire tumor.
- Fig 4.
Scatterplot of the average absolute minimum ADC for all tumors by WHO grading.
- Fig 5.
Receiver operating characteristic curve for manual absolute ADC demonstrates a significant area above the 50% diagonal. Threshold according to the Youden index is ≤0.698 × 10−3 mm2/s for WHO grade III and IV tumors versus grade I and II tumors.
- Fig 6.
A, Summation semi-automated histograms of ADC values of all low-grade tumors compared with high-grade tumors. B, Overlay histograms of all low-grade tumors. C, Overlay histograms of all high-grade tumors.
Tables
- Table 1:
Tumor pathology with corresponding WHO grade and ADC values from manual ROI measurement
Tumor Type WHO Grade Average Minimum ADC × 10−3 mm2/s ADC Ratio Thalamus ADC Ratio White Matter Desmoplastic infantile ganglioglioma I 1.63 1.68 1.50 Desmoplastic infantile ganglioglioma I 0.88 1.05 0.79 Desmoplastic infantile ganglioglioma I 0.97 1.08 0.80 Desmoplastic infantile ganglioglioma I 1.14 0.87 0.76 Choroid plexus papilloma I 1.01 1.05 1.10 Choroid plexus papilloma I 0.92 1.16 0.79 Choroid plexus papilloma I 1.31 1.53 1.23 Pilocytic astrocytoma I 0.78 0.96 0.75 Astrocytoma, focal II 1.71 1.50 1.35 Pilomyxoid astrocytoma II 1.03 1.06 0.71 Astrocytoma, diffuse II 1.12 1.27 0.98 Anaplastic ependymoma III 0.69 0.82 0.59 Anaplastic ependymoma with tanycytic features III 0.54 0.57 0.47 Choroid plexus carcinoma III 1.27 0.93 0.90 Atypical teratoid/rhabdoid tumor IV 0.67 0.53 0.41 Atypical teratoid/rhabdoid tumor IV 0.40 0.55 0.42 Poorly differentiated carcinoma IV 0.56 0.45 0.32 Poorly differentiated carcinoma IV 0.40 0.51 0.35 Glioblastoma IV 0.58 0.62 0.41 P value, t test between low- and high-grade groups .0018 <.0001 .00042 Note:—All 3 parameters were significant between the difference of the means of the low-grade and high-grade groups. Of note, the choroid plexus carcinoma in our study is an outlier in the high-grade group.
- Table 2:
Semi-automated metrics including mean and standard deviations for low- and high-grade tumors
Low-Grade High-Grade P Value (t test) Mean (×10−3 mm2/s) Standard Deviation (×10−3 mm2/s) Mean (×10−3 mm2/s) Standard Deviation (×10−3 mm2/s) Average 1.717 0.377 1.459 0.341 .138 Standard deviation 0.458 0.247 0.616 0.189 .135 Skew 0.803 0.753 1.372 0.704 .111 Kurtosis 1.129 2.515 1.980 2.754 .501 Peak location 1.518 0.493 1.075 0.275 .023a Peak height, normalized 0.088 0.041 0.069 0.029 .258 5th Percentile 1.13 0.151 0.778 0.267 .007a 10th Percentile 1.18 0.151 0.858 0.260 .008a 25th Percentile 1.32 0.180 1.016 0.278 .018a 50th Percentile 1.68 0.453 1.270 0.349 .037a 75th Percentile 2.01 0.598 1.792 0.564 .411 90th Percentile 2.32 0.681 2.363 0.591 .903 95th Percentile 2.50 0.705 2.696 0.541 .518 95th to 5th Percentile 1.377 0.704 1.918 0.560 .080 50th to 5th Percentile 0.555 0.425 0.491 0.273 .695 95th to 50th Percentile 0.821 0.434 1.426 0.362 .004a ↵a Significant P value.
