RT Journal Article
SR Electronic
T1 Value and Limitations of Diffusion-Weighted Imaging in Grading and Diagnosis of Pediatric Posterior Fossa Tumors
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1613
OP 1616
DO 10.3174/ajnr.A2155
VO 31
IS 9
A1 J.L. Jaremko
A1 L.B.O. Jans
A1 L.T. Coleman
A1 M.R. Ditchfield
YR 2010
UL http://www.ajnr.org/content/31/9/1613.abstract
AB SUMMARY: DWI reportedly accurately differentiates pediatric posterior fossa tumors, but anecdotal experience suggests limitations. In 3 years, medulloblastoma and JPA were differentiated by DWI alone in 23/26 cases (88%). Ependymoma (n = 5) could not be reliably differentiated from medulloblastoma or JPA. A trend toward increased diffusion restriction in higher grade tumors (1/14 grade I, 7%; 9/12 grade IV, 75%) had too much overlap to predict the grade of individual cases. The overlap in ADC between tumor types appeared partly due to technical factors (in small, heterogeneous, calcific, or hemorrhagic tumors) but also likely reflected true histologic variability, given that our 3 overlap cases included a desmoplastic medulloblastoma, an anaplastic ependymoma, and a JPA with restricted diffusion in its nodule. Simple structural features (macrocystic tumor, location off midline) aided in distinguishing JPA from the other tumors in these cases. ADCapparent diffusion coefficientADCmeanmean value of ADCADCminminimum value of ADCDWIdiffusion-weighted imagingFLAIRfluid-attenuated inversion recoveryJPAjuvenile pilocytic astrocytomaWHOWorld Health Organization