Korgun Koral MD, Presenter: Nothing to Disclose

Lynn Gargan PhD, Abstract Co-Author: Nothing to Disclose

Kevin Bradley Cederberg MD, Abstract Co-Author: Nothing to Disclose

Daniel C Bowers MD, Abstract Co-Author: Nothing to Disclose

Barjor Gimi PhD, Abstract Co-Author: Nothing to Disclose

To test the accuracy of a flowchart for diagnosis of common pediatric cerebellar tumors based on tumor/normal brain apparent diffusion coefficient (ADC) ratios and age.

79 patients who had preoperative MR imaging and surgical pathology available between 01/2001 and 04/2010 were included. ADC values of solid tumor, normal cerebellum and right thalamus were measured on PACS by a pediatric neuroradiologist. Tumor/ normal brain ratios were calculated and an ROC analysis was performed. The accuracy of a flowchart (Figure) was tested.

There were 31 PAs (pilocytic astrocytoma) [15 males, mean age=7.35 years (1.44-18.73)], 27 MBs (medulloblastoma) [19 males, mean age=6.16 years (1.15-14.18)], 14 ependymomas [13 males, mean age= 4.61 years (0.46-17.18)] and 7 AT/RTs (atypical teratoid/ rhabdoid tumor) [4 males, mean age= 1.06 years (0.25-2.29)]. The mean tumor/ normal cerebellum brain ratios obtained were 2.36 ± 0.44 for PAs, 0.95 ± 0.21 for MBs, for 1.64 ± 0.5 ependymomas, and 0.83 ± 0.11 for AT/RTs; (mean ± std). The ADC values of normal cerebellum and right thalamus were similar. ROC analysis distinguished between PAs and ependymomas (threshold = 1.8033: sensitivity = 93.55, specificity = 78.57) and also between ependymomas and MBs (threshold = 1.2461: sensitivity = 100, specificity = 92.59). MBs and AT/RTs were not significantly distinguishable using ROC analysis and were categorized using age. The proposed flowchart resulted in correct diagnosis in 66 (83.64%) cases.

A flowchart which incorporates tumor:normal brain ADC ratios and patient age for diagnosis of common pediatric cerebellar tumors yields relatively accurate results that can be used in clinical practice.

Cerebellar brain tumors comprise a significant percentage of brain tumors, which are the most common solid neoplasms of childhood. Proposed flowchart may be useful in correct preoperative diagnosis.

Koral, K, Gargan, L, Cederberg, K, Bowers, D, Gimi, B, Utility of Tumor/Normal Brain Apparent Diffusion Coefficient Ratios and Age in Diagnosis of Common Pediatric Cerebellar Tumors.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11011890.html