Minerva Pediatrics 2021 Apr 02

DOI: 10.23736/S2724-5276.21.05955-7

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

The performance of diffusion tensor imaging parameters for the distinction between medulloblastoma and pilocytic astrocytoma

Nguyen MINH DUC ^{1, 2, 3} ✉

¹ Doctoral Program, Department of Radiology, Hanoi Medical University, Ha Noi, Vietnam; ² Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam; ³ Department of Radiology, Children’s Hospital 02, Ho Chi Minh City, Vietnam

BACKGROUND: To evaluate the performance of diffusion tensor imaging (DTI) parameters for the distinction between pediatric medulloblastomas and pilocytic astrocytomas.
METHODS: DTI was performed in 36 patients, who were divided into two groups: group 1 consisted of 26 patients with medulloblastoma, whereas group 2 consisted of 10 patients with pilocytic astrocytoma. The Mann-Whitney U test was utilized to compare the tumoral fractional anisotropy (tFA) and diffusivity (tMD) values and the tumor to parenchyma ratios for these values (rFA and rMD, respectively) between these two groups. Receiver operating characteristic (ROC) curve analysis and the Youden index were applied to compute the cut-off point, and then the area under the curve (AUC), sensitivity, and specificity were calculated.
RESULTS: The tFA and rFA values of group 1 were significantly lower than those of group 2 (p < 0.05). In contrast, the tMD and rMD values of group 1 were significantly higher than those of group 2 (p < 0.05). Among the FA parameters, a cut-off tFA value of 0.37 provided the best ability to discriminate between medulloblastomas and pilocytic astrocytomas, producing a sensitivity value of 84.6%, a specificity of 80%, and an AUC of 81.7%. The cut-off values for MD and rMD were determined to be 1.06 × 10-3 mm2/s and 1.33, respectively, and were determined to be the most efficacious parameters for the differential diagnosis between medulloblastoma and pilocytic astrocytoma, which generated sensitivity, specificity, and AUC values of 100%.
CONCLUSIONS: DTI parameters can play pivotal roles in the discrimination between medulloblastoma and pilocytic astrocytoma.

KEY WORDS: Medulloblastoma; Pilocytic astrocytoma; Magnetic resonance imaging; DTI parameters