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Pediatric Posterior Fossa Medulloblastoma: The Role of Diffusion Imaging in Identifying Molecular Groups
Author(s) -
Reddy Nihaal,
Ellison David W.,
Soares Bruno P.,
Carson Kathryn A.,
Huisman Thierry A. G. M.,
Patay Zoltan
Publication year - 2020
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12704
Subject(s) - medulloblastoma , medicine , sonic hedgehog , diffusion imaging , effective diffusion coefficient , ptch1 , wnt signaling pathway , posterior fossa , nuclear medicine , pathology , magnetic resonance imaging , radiology , diffusion mri , biology , genetics , signal transduction , gene
BACKGROUND AND PURPOSE The molecular groups WNT activated (WNT), Sonic hedgehog activated (SHH), group 3, and group 4 are biologically and clinically distinct forms of medulloblastoma. We evaluated apparent diffusion coefficient (ADC) values’ utility in differentiating/predicting medulloblastoma groups at the initial diagnostic imaging evaluation and prior to surgery. METHODS We retrospectively measured the ADC values of the enhancing, solid portion of the tumor (EST) and of the whole tumor (WT) and performed Kruskal‐Wallis testing to compare the absolute tumor ADC values and cerebellar and thalamic ratios of three medulloblastoma groups (WNT, SHH, and group 3/group 4 combined). RESULTS Ninety‐three children (65 males) were included. Fifty‐seven children had group 3/group 4, 27 had SHH, and 9 had WNT medulloblastomas. The median absolute ADC values in the EST and WT were .719 × 10 −3 and .864 × 10 −3 mm 2 /s for group 3/group 4; .660 × 10 −3 and .965 × 10 −3 mm 2 /s for SHH; and .594 × 10 −3 and .728 × 10 −3 mm 2 /s for WNT medulloblastomas ( P = .02 and .13). The median ratio of ADC values in the EST or the WT to normal cerebellar tissue was highest for group 3/group 4 and lowest for WNT medulloblastomas ( P = .03 and .09), with similar results in pairwise comparisons of the corresponding thalamic ADC values ( P = .02 and .06). CONCLUSION ADC analysis of a tumor's contrast‐enhancing solid portion may aid preoperative molecular classification/prediction of pediatric medulloblastomas and may facilitate optimal surgical treatment planning, reducing surgery‐induced morbidity.