Utility of Apparent Diffusion Coefficient Ratios in Distinguishing Common Pediatric Cerebellar Tumors

Gimi, Barjor; Cederberg, Kevin B; Derinkuyu, Betül Emine; Gargan, Lynn; Koral, Kadriye M.; Bowers, Daniel C.; Koral, Korgün

doi:10.1016/j.acra.2012.03.004

Cited by 62 publications

(63 citation statements)

References 16 publications

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“…Park et al (17) recommend that the ADC values of breast lesions must be compared with that of normal fibroglandular tissue because the ADC value is variable with the gradient factor b. ADCs were determined using linear regression analysis and analysis of the natural log of the signal intensity versus the gradient factor b (18). Gimi et al (19) and El Khauli et al (5) reported that adding ADC ratio values to conventional MR data improved the diagnostic performance of the MRI. El Khauli et al (5) used the term "normalized ADC" instead of "ADC ratio".…”

Section: Discussionmentioning

confidence: 99%

The role of apparent diffusion coefficient values in the differential diagnosis of breast lesions in diffusion-weighted MRI

Şahin

Arıbal

2013

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to determine the apparent diffusion coefficients (ADCs) of focal breast lesions on diffusion-weighted magnetic resonance imaging (DW-MRI) and to evaluate whether ADC measurement can be used to characterize lesions as benign or malignant. MATERIALS AND METHODSFifty-one patients between the ages of 18-79 years (mean age, 48.5 years) with 51 histopathologically verified breast lesions were included in this study. The patients were examined with a 1.5 Tesla system using a bilateral phased-array breast coil. Spin-echo echo-planar imaging was used. The images were obtained with b values of 50, 400, and 800 s/ mm 2 . The ADC values were calculated for breast lesions and for normal fibroglandular tissue. Receiver operating characteristics analyses were performed to find the threshold ADC values. /s (sensitivity, 88.5%; specificity, 100%). With the ADC ratio (lesion to normal fibroglandular tissue), the threshold was 0.8 (sensitivity, 91.4%; specificity, 100%). The ADC value obtained from malignant lesions was statistically different from that of benign lesions (P < 0.001). CONCLUSION Diffusion-weighted imaging can be used to differentiate malignant and benign breast lesions. RESULTS Breast cancer is one of the leading causes of death from cancer in women (1). The use of magnetic resonance imaging (MRI) has a relatively short history for the diagnosis of breast lesions. Breast MRI-as a different diagnostic tool from mammography and ultrasonography (US)-can show tissue perfusion characteristics of the masses on breast parenchyma, as well as morphologic features, such as the contour, size, and shape of the breast lesions. Although conventional MRI sequences have an important role in the differential diagnosis of breast masses, this technology has a low specificity, thus requires the support of additional imaging techniques (2-4). Diffusion-weighted MRI (DW-MRI) is an active field of research in MRI. In addition to diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) maps can be created, and quantitative measurements can be performed. Recent studies have shown a high accuracy rate in the differentiation between malignant and benign breast lesions using DW-MRI and ADC measurements (5-7). The measured ADC values were significantly lower in malignant lesions compared with benign lesions. Malignant breast tumors show a high amount of cellular structure (due to the intensity of the tumor tissue), resulting in low ADC values for these lesions (5-7).The aim of this study was to evaluate the value of DWI and ADC values in the differential diagnosis of benign and malignant breast lesions. Materials and methods Patient selectionPatients with a suspicious mass diagnosed with mammography or US that were considered for a biopsy procedure were included in this prospective study.The local ethics committee approved the study, and informed written consent was obtained from each patient.Seventy patients who had a suspicious lesion on mammography or US according to Breast Imaging-Reporting a...

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Section: Discussionmentioning

confidence: 99%

The role of apparent diffusion coefficient values in the differential diagnosis of breast lesions in diffusion-weighted MRI

Şahin

Arıbal

2013

Diagn Interv Radiol

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“…13,14,15,16 Several of these studies used DWI to distinguish between different types of paediatric posterior fossa tumours, but there were many limitations [14][15][16][17][18] . To our knowledge, the present study is the first to have specifically sought to grade ependymomas in children.…”

Section: Discussionmentioning

confidence: 99%

Prognostic and predictive values of diffusion and perfusion MRI in paediatric intracranial ependymomas in a large national study

Tensaouti

Ducassou

Chaltiel

et al. 2016

BJR

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Objective: To assess the relative cerebral blood volume (rCBV) and apparent diffusion coefficient (ADC) derived, respectively, from perfusion and diffusion pre-operative MRI of intracranial ependymomas and their predictive and prognostic values. Methods: Pre-operative MRI and clinical data for intracranial ependymomas diagnosed between January 2000 and December 2013 were retrospectively retrieved from a web-based national database. MRI data included diffusion (62 patients) and perfusion (20 patients) MRI. Patient age, histopathological diagnosis, tumour location, ADC, relative ADC (rADC) and rCBV were considered as potential factors in a survival analysis. Survival rates were estimated using the Kaplan-Meier method. Univariate analyses were performed using the log-rank test to compare groups. We also performed a multivariate analysis, applying the Cox proportional hazards model.Results: ADC and rADC values within hypointense regions differed significantly between grades II and III (p 5 0.01). The 75th percentile of ADC within hypointense regions and the 25th percentile of rCBV within nonenhancing lesions were prognostic of disease-free survival (p 5 0.004, p 5 0.05). A significant correlation was found between the 75th percentile of rCBV and the 25th percentile of rADC (p 5 0.01) in enhancing regions of grade-III tumours. Conclusion: Pre-operative rADC and rCBV could be used as prognostic factors for clinical outcome and to predict histological grade in paediatric ependymomas. Advances in knowledge: Prognostic value of diffusion and perfusion MRI in paediatric ependymoma was found and may play a role in the prognostic classification of patients in order to design more tailored treatment strategies.

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“…A single ROI was placed on the normal contralateral thalamus because the thalamus provides a reliable internal control as it maintains its normal signal intensity on diffusion MR imaging even in cases of marked hydrocephalus. 5 Mean tumor ADC values and tumor to normal brain ADC ratios were calculated. The head CT examinations were assessed for calcifications and hemorrhage.…”

Section: Methodsmentioning

confidence: 99%

Pleomorphic Xanthoastrocytoma of Childhood: MR Imaging and Diffusion MR Imaging Features

Moore¹,

Mathis

Gargan

et al. 2014

AJNR Am J Neuroradiol

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Utility of Apparent Diffusion Coefficient Ratios in Distinguishing Common Pediatric Cerebellar Tumors

Cited by 62 publications

References 16 publications

The role of apparent diffusion coefficient values in the differential diagnosis of breast lesions in diffusion-weighted MRI

The role of apparent diffusion coefficient values in the differential diagnosis of breast lesions in diffusion-weighted MRI

Prognostic and predictive values of diffusion and perfusion MRI in paediatric intracranial ependymomas in a large national study

Pleomorphic Xanthoastrocytoma of Childhood: MR Imaging and Diffusion MR Imaging Features

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