Applicability of apparent diffusion coefficient ratios in preoperative diagnosis of common pediatric cerebellar tumors across two institutions

Korgün Koral, Raphael Alford, Nabila Choudhury, Mahmud Mossa-Basha, Lynn Gargan, Barjor Gimi, Ang Gao, Song Zhang, Daniel C. Bowers, Kadriye M. Koral, Izlem Izbudak

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Introduction The purpose of our study was to test the accuracy and applicability of decision rules utilizing apparent diffusion coefficient (ADC) ratios on accurate preoperative diagnosis of common pediatric cerebellar tumors across two institutions. Methods In this HIPAA-compliant, IRB-approved study, performed at two institutions, 140 pediatric cerebellar tumors were included. Two separate reviewers placed regions of interest on the solid components of 140 tumors (98 at site A and 42 at site B) and normal brain on the ADC maps. The third reviewer who was blinded to the histopathological diagnoses made the same measurements on 140 patients to validate the data. Tumor to normal brain ADC ratios were calculated. Receiver operator curve (ROC) analysis was performed to generate thresholds to discriminate tumors. Utility of decision rules based on these thresholds was tested. Results While ADC values of medulloblastomas were different between the sites, there was no difference among the ADC ratios of medulloblastomas, pilocytic astrocytomas, ependymomas, and atypical teratoid rhabdoid tumors between the sites. ADC ratio of ≥1.8 correctly discriminated pilocytic astrocytomas from ependymomas with a sensitivity of 0.83 and a specificity of 0.78. ADC ratio of <1.2 correctly discriminated ependymomas from embryonal tumors with a sensitivity of 0.87 and a specificity of 0.83. The proposed decision rules correctly discriminated 120 of the 140 tumors (85.71 %). Age ≥2 years criterion correctly sorted medulloblastomas in 84.48 % of patients and age <2 years correctly distinguished atypical teratoid rhabdoid tumors in 90.00 % of patients with embryonal tumors. Conclusions Decision rules based on ADC ratios are applicable across two institutions in the accurate preoperative diagnosis of common pediatric cerebellar tumors.

Original languageEnglish (US)
JournalNeuroradiology
DOIs
StateAccepted/In press - Jun 29 2014

Fingerprint

Cerebellar Neoplasms
Pediatrics
Ependymoma
Medulloblastoma
Neoplasms
Astrocytoma
Health Insurance Portability and Accountability Act
Research Ethics Committees
Brain

Keywords

  • Apparent diffusion coefficient
  • Cerebellar tumor
  • Diffusion MR
  • Pediatric

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging

Cite this

Applicability of apparent diffusion coefficient ratios in preoperative diagnosis of common pediatric cerebellar tumors across two institutions. / Koral, Korgün; Alford, Raphael; Choudhury, Nabila; Mossa-Basha, Mahmud; Gargan, Lynn; Gimi, Barjor; Gao, Ang; Zhang, Song; Bowers, Daniel C.; Koral, Kadriye M.; Izbudak, Izlem.

In: Neuroradiology, 29.06.2014.

Research output: Contribution to journalArticle

Koral, Korgün ; Alford, Raphael ; Choudhury, Nabila ; Mossa-Basha, Mahmud ; Gargan, Lynn ; Gimi, Barjor ; Gao, Ang ; Zhang, Song ; Bowers, Daniel C. ; Koral, Kadriye M. ; Izbudak, Izlem. / Applicability of apparent diffusion coefficient ratios in preoperative diagnosis of common pediatric cerebellar tumors across two institutions. In: Neuroradiology. 2014.
@article{c0cc049b6f43406e970b795fc6c8ff2b,
title = "Applicability of apparent diffusion coefficient ratios in preoperative diagnosis of common pediatric cerebellar tumors across two institutions",
abstract = "Introduction The purpose of our study was to test the accuracy and applicability of decision rules utilizing apparent diffusion coefficient (ADC) ratios on accurate preoperative diagnosis of common pediatric cerebellar tumors across two institutions. Methods In this HIPAA-compliant, IRB-approved study, performed at two institutions, 140 pediatric cerebellar tumors were included. Two separate reviewers placed regions of interest on the solid components of 140 tumors (98 at site A and 42 at site B) and normal brain on the ADC maps. The third reviewer who was blinded to the histopathological diagnoses made the same measurements on 140 patients to validate the data. Tumor to normal brain ADC ratios were calculated. Receiver operator curve (ROC) analysis was performed to generate thresholds to discriminate tumors. Utility of decision rules based on these thresholds was tested. Results While ADC values of medulloblastomas were different between the sites, there was no difference among the ADC ratios of medulloblastomas, pilocytic astrocytomas, ependymomas, and atypical teratoid rhabdoid tumors between the sites. ADC ratio of ≥1.8 correctly discriminated pilocytic astrocytomas from ependymomas with a sensitivity of 0.83 and a specificity of 0.78. ADC ratio of <1.2 correctly discriminated ependymomas from embryonal tumors with a sensitivity of 0.87 and a specificity of 0.83. The proposed decision rules correctly discriminated 120 of the 140 tumors (85.71 {\%}). Age ≥2 years criterion correctly sorted medulloblastomas in 84.48 {\%} of patients and age <2 years correctly distinguished atypical teratoid rhabdoid tumors in 90.00 {\%} of patients with embryonal tumors. Conclusions Decision rules based on ADC ratios are applicable across two institutions in the accurate preoperative diagnosis of common pediatric cerebellar tumors.",
keywords = "Apparent diffusion coefficient, Cerebellar tumor, Diffusion MR, Pediatric",
author = "Korg{\"u}n Koral and Raphael Alford and Nabila Choudhury and Mahmud Mossa-Basha and Lynn Gargan and Barjor Gimi and Ang Gao and Song Zhang and Bowers, {Daniel C.} and Koral, {Kadriye M.} and Izlem Izbudak",
year = "2014",
month = "6",
day = "29",
doi = "10.1007/s00234-014-1398-z",
language = "English (US)",
journal = "Neuroradiology",
issn = "0028-3940",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Applicability of apparent diffusion coefficient ratios in preoperative diagnosis of common pediatric cerebellar tumors across two institutions

AU - Koral, Korgün

AU - Alford, Raphael

AU - Choudhury, Nabila

AU - Mossa-Basha, Mahmud

AU - Gargan, Lynn

AU - Gimi, Barjor

AU - Gao, Ang

AU - Zhang, Song

AU - Bowers, Daniel C.

AU - Koral, Kadriye M.

AU - Izbudak, Izlem

PY - 2014/6/29

Y1 - 2014/6/29

N2 - Introduction The purpose of our study was to test the accuracy and applicability of decision rules utilizing apparent diffusion coefficient (ADC) ratios on accurate preoperative diagnosis of common pediatric cerebellar tumors across two institutions. Methods In this HIPAA-compliant, IRB-approved study, performed at two institutions, 140 pediatric cerebellar tumors were included. Two separate reviewers placed regions of interest on the solid components of 140 tumors (98 at site A and 42 at site B) and normal brain on the ADC maps. The third reviewer who was blinded to the histopathological diagnoses made the same measurements on 140 patients to validate the data. Tumor to normal brain ADC ratios were calculated. Receiver operator curve (ROC) analysis was performed to generate thresholds to discriminate tumors. Utility of decision rules based on these thresholds was tested. Results While ADC values of medulloblastomas were different between the sites, there was no difference among the ADC ratios of medulloblastomas, pilocytic astrocytomas, ependymomas, and atypical teratoid rhabdoid tumors between the sites. ADC ratio of ≥1.8 correctly discriminated pilocytic astrocytomas from ependymomas with a sensitivity of 0.83 and a specificity of 0.78. ADC ratio of <1.2 correctly discriminated ependymomas from embryonal tumors with a sensitivity of 0.87 and a specificity of 0.83. The proposed decision rules correctly discriminated 120 of the 140 tumors (85.71 %). Age ≥2 years criterion correctly sorted medulloblastomas in 84.48 % of patients and age <2 years correctly distinguished atypical teratoid rhabdoid tumors in 90.00 % of patients with embryonal tumors. Conclusions Decision rules based on ADC ratios are applicable across two institutions in the accurate preoperative diagnosis of common pediatric cerebellar tumors.

AB - Introduction The purpose of our study was to test the accuracy and applicability of decision rules utilizing apparent diffusion coefficient (ADC) ratios on accurate preoperative diagnosis of common pediatric cerebellar tumors across two institutions. Methods In this HIPAA-compliant, IRB-approved study, performed at two institutions, 140 pediatric cerebellar tumors were included. Two separate reviewers placed regions of interest on the solid components of 140 tumors (98 at site A and 42 at site B) and normal brain on the ADC maps. The third reviewer who was blinded to the histopathological diagnoses made the same measurements on 140 patients to validate the data. Tumor to normal brain ADC ratios were calculated. Receiver operator curve (ROC) analysis was performed to generate thresholds to discriminate tumors. Utility of decision rules based on these thresholds was tested. Results While ADC values of medulloblastomas were different between the sites, there was no difference among the ADC ratios of medulloblastomas, pilocytic astrocytomas, ependymomas, and atypical teratoid rhabdoid tumors between the sites. ADC ratio of ≥1.8 correctly discriminated pilocytic astrocytomas from ependymomas with a sensitivity of 0.83 and a specificity of 0.78. ADC ratio of <1.2 correctly discriminated ependymomas from embryonal tumors with a sensitivity of 0.87 and a specificity of 0.83. The proposed decision rules correctly discriminated 120 of the 140 tumors (85.71 %). Age ≥2 years criterion correctly sorted medulloblastomas in 84.48 % of patients and age <2 years correctly distinguished atypical teratoid rhabdoid tumors in 90.00 % of patients with embryonal tumors. Conclusions Decision rules based on ADC ratios are applicable across two institutions in the accurate preoperative diagnosis of common pediatric cerebellar tumors.

KW - Apparent diffusion coefficient

KW - Cerebellar tumor

KW - Diffusion MR

KW - Pediatric

UR - http://www.scopus.com/inward/record.url?scp=84903243895&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84903243895&partnerID=8YFLogxK

U2 - 10.1007/s00234-014-1398-z

DO - 10.1007/s00234-014-1398-z

M3 - Article

C2 - 24974083

AN - SCOPUS:84939886404

JO - Neuroradiology

JF - Neuroradiology

SN - 0028-3940

ER -