Whole-tumor histogram analysis of apparent diffusion coefficient maps in grading diagnosis of ependymoma

Abstract

Objective To study the value of whole-tumor histogram analysis which is based on apparent diffusion coefficient maps in grading diagnosis of ependymoma. Methods 71 patients with ependymal tumors were retrospectively analyzed, including 13 cases of WHO grade I, 28 cases of WHO grade II, and 30 cases of WHO grade III. Mazda software was used to draw the region of interest (ROI) in the apparent diffusion coefficient maps of three groups on every layer of tumor level. The whole-tumor gray histogram analysis was carried to obtained nine characteristic parameters, including mean, variance, kurtosis, skewness, Perc.01%, Perc.10%, Perc.50%, Perc.90%, and Perc.99%. When the parameters satisfy the test of normal distribution and homogeneity of variance, single factor analysis of variance (ANOVA) was carried to compare the three groups and LSD t test was performed to compare the two groups. Besides, the ROC curve was used to analyze the diagnostic efficacy of the parameters. Results Variance, Perc.01%, and Perc.10% had significant differences among the three groups (all P < 0.05). The remaining six parameters had no significant difference among the three groups (all P > 0.05). And, between WHO I and WHO II, the sensitivity and specificity of the Perc.10% were 85.7% and 100.0%, the AUC was 0.872, and the cutoff was 126.5. Between WHO I and WHO III, the sensitivity and specificity of the Perc.10% were 85.7% and 87.7%, the AUC was 0.835, and the optimum critical value was 131.33. Besides, the sensitivity, specificity, and AUC of variance between WHO II and WHO III are 68.4%, 76.9%, 0.794, and 2645.7, respectively. They had higher identification efficiency. Conclusion Whole-tumor histogram analysis of apparent diffusion coefficient (ADC) maps could provide ancillary diagnostic value in grading diagnosis of ependymoma. Perc.10% had a high diagnostic efficiency.

Role of Diffusion-weighted MRI in Differentiation between Benign and Malignant Anterior Mediastinal Masses

“…In agreement with our result, Kong et al demonstrated that ADC10 showed best differentiating ability for discriminating low-risk thymoma from high-risk thymoma and thymic carcinoma [9]. Huang et al found that ADC10 was helpful in WHO grading of ependymoma [15]. Similarly, Donati et al showed that ADC10 correlated with Gleason score better than the other ADC did, suggesting that the 10th percentile ADC may be the best for distinguishing low-from intermediate-or high-grade prostate cancer [16].…”

Role of diffusion-weighted MRI in differentiation between benign and malignant anterior mediastinal masses

“…The superior performance of the low percentile ADCs obtained by the histogram approach was also demonstrated in characterizing tumors of other organs. Huang et al found that the ADC 10 was helpful in WHO grading of ependymoma(23). Donati et al showed that ADC 10 correlated with the Gleason score better than the other ADC parameters did, suggesting that the 10th percentile ADC may be the best for distinguishing low-from intermediate-or high-grade prostate cancer (24).…”