Dynamic susceptibility contrast and diffusion-weighted MRI in posterior fossa pilocytic astrocytoma and medulloblastoma

Authors

Ryo Kurokawa, Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.
Yoshie Umemura, Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Aristides Capizzano, Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.
Mariko Kurokawa, Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.
Akira Baba, Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.
Adam Holmes, Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.
John Kim, Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.
Yoshiaki Ota, Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.
Ashok Srinivasan, Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.
Toshio Moritani, Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.

Document Type

Article

Abstract

BACKGROUND AND PURPOSE: The utility of perfusion MRI in distinguishing between pilocytic astrocytoma (PA) and medulloblastoma (MB) is unclear. This study aimed to evaluate the diagnostic and prognostic performance of dynamic susceptibility contrast (DSC)-MRI parameters and apparent diffusion coefficient (ADC) values between PA and MB. METHODS: Between January 2012 and August 2021, 49 (median, 7 years [range, 1-28 years]; 28 females) and 35 (median, 8 years [1-24 years]; 12 females) patients with pathologically confirmed PA and MB, respectively, were included. The normalized relative cerebral blood volume and flow (nrCBV and nrCBF) and mean and minimal normalized ADC (nADCmean and nADCmin) values were calculated using volume-of-interest analyses. Diagnostic performance and Pearson's correlation with progression-free survival were also evaluated. RESULTS: The MB group showed a significantly higher nrCBV and nrCBF (nrCBV: 1.69 [0.93-4.23] vs. 0.95 [range, 0.37-2.28], p = .0032; nrCBF: 1.62 [0.93-3.16] vs. 1.07 [0.46-2.26], p = .0084) and significantly lower nADCmean and nADCmin (nADCmean: 0.97 [0.70-1.68] vs. 2.21 [1.44-2.80], p < .001; nADCmin: 0.50 [0.19-0.89] vs. 1.42 [0.89-2.20], p < .001) than the PA group. All parameters exhibited good diagnostic ability (accuracy >0.80) with nADCmin achieving the highest score (accuracy = 1). A moderate correlation was found between nADCmean and progression-free survival for MB (r = 0.44, p = .0084). CONCLUSIONS: DSC-MRI parameters and ADC values were useful for distinguishing between PA and MB. A lower ADC indicated an unfavorable MB prognosis, but the DSC-MRI parameters did not correlate with progression-free survival in either group.

Medical Subject Headings

Astrocytoma (diagnostic imaging); Cerebellar Neoplasms (diagnostic imaging); Diffusion Magnetic Resonance Imaging (methods); Female; Humans; Magnetic Resonance Imaging (methods); Male; Medulloblastoma (diagnostic imaging); Retrospective Studies

Publication Date

5-1-2022

Publication Title

Journal of neuroimaging : official journal of the American Society of Neuroimaging

E-ISSN

1552-6569

Volume

32

Issue

3

First Page

511

Last Page

520

PubMed ID

34997668

Digital Object Identifier (DOI)

10.1111/jon.12962

Recommended Citation

Kurokawa, Ryo; Umemura, Yoshie; Capizzano, Aristides; Kurokawa, Mariko; Baba, Akira; Holmes, Adam; Kim, John; Ota, Yoshiaki; Srinivasan, Ashok; and Moritani, Toshio, "Dynamic susceptibility contrast and diffusion-weighted MRI in posterior fossa pilocytic astrocytoma and medulloblastoma" (2022). Neurology. 1448.
https://scholar.barrowneuro.org/neurology/1448