The Role of Apparent Diffusion Coefficient in the Differentiation between Cerebellar Medulloblastoma and Brainstem Glioma

Abstract

For certain clinical circumstances, the differentiation between cerebellar medulloblastoma and brainstem glioma is essential. We aimed to evaluate the role played by the apparent diffusion coefficient (ADC) values in the differentiation between cerebellar medulloblastomas and brainstem gliomas in children. The institutional review board approved this prospective study. Brain magnetic resonance imaging (MRI), including diffusion-weighted imaging (DWI) and ADC, was assessed in 32 patients (median age: 7.0 years), divided into two groups, a medulloblastoma group (group 1, n = 22) and a brainstem glioma group (group 2, n = 10). The Mann–Whitney U test was utilized to compare tumor ADCmax, ADCmin, ADCmean, and ADCsd values, and their ratios with the parenchyma values between the two groups. Receiver operating characteristic (ROC) curve analysis and the Youden index were used to calculate the cut-off value, along with the area under the curve (AUC), sensitivity, and specificity. The median ADCmax, ADCmin, and ADCmean values were significantly higher in group 2 than in group 1 (p < 0.05). The median ratios of ADCmin and ADCmean to the parenchyma were significantly higher in group 2 than in group 1 (p < 0.05). The ROC analysis showed that the AUC for the ADCmean ratio was the highest among these parameters, at 98.2%. The ADCmean tumor to parenchyma ratio was a significant and effective parameter for the differentiation between pediatric medulloblastomas and brainstem gliomas.

Systematic analysis of MCM3 in pediatric medulloblastoma via multi-omics analysis

“…Non-invasive methods have made great advances with the identification of molecular subtypes based on DNA methylation. Similarly, as another clinical evaluation method, magnetic resonance imaging (MRI) also helps the differentiation of medulloblastoma from other pediatric brain tumors and risk stratification based on different features of T1 and T2-weighted MRI ( Duc et al, 2020 ; Minh Thong and Minh Duc, 2020 ; Zhang et al, 2022 ). In addition, cellular proliferation plays an essential role in tumor content, especially in highly malignant cancers ( Gu et al, 2021 ; McCarthy et al, 2021 ; Newman et al, 2021 ; Qiu et al, 2021 ).…”

Medulloblastoma in the cerebellopontine angle mimicking a schwannoma

“…Computed tomography (CT) reveals a well‐defined mass with heterogeneous contrast enhancement at CPA, while MRI shows a well‐defined mass with low signal intensity on T1‐weighted images and iso‐to‐high signal intensity on T2‐weighted images 5,16 . Due a high rate of cellular division and densely packed cells, the diffusion of the tumor is restricted and the tumor will manifest mostly as a homogeneous enhancement with the administration of gadolinium contrast 5,16‐18 . In this case report, even though patient underwent advanced MRI sequences, the exact diagnosis of CPA medulloblastoma was dismissed since radiological information on CPA medulloblastoma and vestibular schwannoma was not understood thoroughly.…”

A rare, pediatric, fourth-ventricular, anaplastic astrocytoma

“…In a previous by Thong et al. [10] , the mean ADC value of midline brainstem glioma was 1.39 × 10 −3 mm 2 /s. In addition, in another study by Duc et al.…”