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. 2020 Oct 29;12(3):34-40.
doi: 10.3390/neurolint12030009.

The Role of Apparent Diffusion Coefficient in the Differentiation between Cerebellar Medulloblastoma and Brainstem Glioma

Pham Minh Thong  1 , Nguyen Minh Duc  1   2   3
Affiliations

The Role of Apparent Diffusion Coefficient in the Differentiation between Cerebellar Medulloblastoma and Brainstem Glioma

Pham Minh Thong et al. Neurol Int. .

Abstract

For certain clinical circumstances, the differentiation between cerebellar medulloblastoma and brainstem glioma is essential. We aimed to evaluate the role played by the apparent diffusion coefficient (ADC) values in the differentiation between cerebellar medulloblastomas and brainstem gliomas in children. The institutional review board approved this prospective study. Brain magnetic resonance imaging (MRI), including diffusion-weighted imaging (DWI) and ADC, was assessed in 32 patients (median age: 7.0 years), divided into two groups, a medulloblastoma group (group 1, n = 22) and a brainstem glioma group (group 2, n = 10). The Mann-Whitney U test was utilized to compare tumor ADCmax, ADCmin, ADCmean, and ADCsd values, and their ratios with the parenchyma values between the two groups. Receiver operating characteristic (ROC) curve analysis and the Youden index were used to calculate the cut-off value, along with the area under the curve (AUC), sensitivity, and specificity. The median ADCmax, ADCmin, and ADCmean values were significantly higher in group 2 than in group 1 (p < 0.05). The median ratios of ADCmin and ADCmean to the parenchyma were significantly higher in group 2 than in group 1 (p < 0.05). The ROC analysis showed that the AUC for the ADCmean ratio was the highest among these parameters, at 98.2%. The ADCmean tumor to parenchyma ratio was a significant and effective parameter for the differentiation between pediatric medulloblastomas and brainstem gliomas.

Keywords: apparent diffusion coefficient; brainstem glioma; cerebellar medulloblastoma; magnetic resonance imaging.

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Conflict of interest statement

There are no conflicts of interest to declare.

Figures

Figure 1
Figure 1
An 8-year-old male patient had a tumor inside the fourth ventricle, which was confirmed as medulloblastoma after surgery. (Left) Axial diffusion-weighted image (DWI). (Right) apparent diffusion coefficient (ADC) map.
Figure 2
Figure 2
A 10-year-old male patient had a tumor located in the pons, which was diagnosed as a diffuse glioma. (Left) Axial DWI image. (Right) ADC map.
Figure 3
Figure 3
The ROC curves for the ADCmax, ADCmin, ADCmean, rADCmin, and rADCmean values.
See this image and copyright information in PMC

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