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THE VALUE OF DIFFUSION MAGNETIC RESONANCE IN THE DIFFERENTIAL DIAGNOSIS OF MEDULLOBLASTOMA AND EPENDYMOMA FOSSA VENTRICULAR IN CHILDREN
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Abstract
Objectives: This study was designed to investigate the value of apparent diffusion value (ADC) of magnetic resonance imaging in differentiating ependymoma and medulloblastoma.
Methods: Retrospective study was conducted on 64 pediatric patients with posterior fossa brain tumors who underwent biopsy and surgical diagnosis confirming the pathology as ependymoma or medulloblastoma. They underwent contrast-enhanced MRI scans at Viet Duc Friendship Hospital and National Children's Hospital from January 2020 to December 2023. The evaluation of ADC parameters (mean, max, min) was performed using the whole tumor volume of interest (VOI) method.
Results: The ADC mean value has high differential diagnostic significance with AUC = 0.911, the cut-off value (sensitivity %, specificity %) is 844 x10-6m2/s (94%, 83%). The value of ADC min is meaningful, the diagnostic ability is lower with AUC = 0.743, the cut-off value of ADC min is 487 x10-6m2/s with Se of 75% and Sp of 90%.
The mean ADC and minimum ADC values help differentiate between ependymoma or medulloblastoma with p=0.01. Based on the mean ADC value (AUC 0.911), which provides better diagnostic accuracy compared to the minimum ADC value (AUC 0.43), at a cut-off ADC mean value of 844 x10-6m2/s for distinguishing between the two types of tumors, the sensitivity and specificity are 94% and 83%, respectively. At a cut-off ADC min value of 487 x10-6 mm2/s for distinguishing between the two types of tumors, the sensitivity and specificity are 75% and 90%, respectively.
Conclusion: The mean ADC and minimum ADC values at the solid part of the tumor are significant in distinguishing between ependymoma and medulloblastoma.
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Keywords
Pediatric brain tumor, medulloblastoma, ependymoma, magnetic resonance, apparent diffusion coefficient
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