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Role of susceptibility-weighted imaging and intratumoral susceptibility signals in grading and differentiating pediatric brain tumors at 1.5 T: a preliminary study.
Neuroradiology ( IF 2.8 ) Pub Date : 2020-03-06 , DOI: 10.1007/s00234-020-02386-z
Simona Gaudino 1 , Giammaria Marziali 1, 2 , Giovanna Pezzullo 3 , Pamela Guadalupi 1, 2 , Carolina Giordano 1, 2 , Amato Infante 4 , Massimo Benenati 1, 2 , Antonia Ramaglia 1, 2 , Luca Massimi 5, 6 , Marco Gessi 7 , Paolo Frassanito 5 , Massimo Caldarelli 5, 6 , Cesare Colosimo 1, 2
Affiliation  

PURPOSE Susceptibility-weighted imaging (SWI) is useful for glioma grading and discriminating between brain tumor categories in adults, but its diagnostic value for pediatric brain tumors is unclear. Here we evaluated the usefulness of SWI for pediatric tumor grading and differentiation by assessing intratumoral susceptibility signal intensity (ITSS). METHODS We retrospectively enrolled 96 children with histopathologically diagnosed brain tumors, who underwent routine brain MRI exam with SWI (1.5 T scanner). Each tumor was assigned an ITSS score by a radiology resident and an experienced neuroradiologist, and subsequently by consensus. Statistical analyses were performed to differentiate between low-grade (LG) and high-grade (HG) tumors, histological categories, and tumor locations. Inter-reader agreement was assessed using Cohen's kappa (κ). RESULTS The interobserver agreement was 0.844 (0.953 between first reader and consensus, and 0.890 between second reader and consensus). Among all tumors, we found a statistically significant difference between LG and HG for ITSS scores of 0 and 2 (p = 0.002). This correlation was weaker among astrocytomas alone, and became significant when considering only off-midline astrocytomas (p = 0.05). Scores of 0 and 2 were a strong discriminating factor (p = 0.001) for astrocytomas (score 0) and for embryonal, choroid plexus, germ-cell, pineal, and ependymoma tumors (score 2). No medulloblastoma showed a score of 0. CONCLUSIONS Our preliminary ITTS results in pediatric brain tumors somewhat differed from those obtained in adult populations. These findings highlight the potential valuable role of ITSS for tumor grading and discriminating between some tumor categories in the pediatric population.

中文翻译:

敏感度加权成像和肿瘤内敏感度信号在1.5 T分级和区分小儿脑肿瘤中的作用:一项初步研究。

目的磁化加权成像(SWI)可用于成人脑胶质瘤分级和区分脑瘤类别,但尚不清楚其对儿科脑瘤的诊断价值。在这里,我们通过评估肿瘤内敏感性信号强度(ITSS)来评估SWI在儿科肿瘤分级和分化中的作用。方法我们回顾性研究了96例经病理组织学诊断为脑肿瘤的儿童,他们接受了SWI(1.5 T扫描仪)常规脑MRI检查。放射科住院医师和经验丰富的神经放射科医师为每个肿瘤分配了ITSS评分,并随后达成共识。进行统计分析以区分低度(LG)和高度(HG)肿瘤,组织学类型和肿瘤位置。使用Cohen的κ(κ)评估阅读者之间的同意。结果观察者之间的一致性为0.844(第一读者与共识之间为0.953,第二读者与共识之间为0.890)。在所有肿瘤中,我们发现LG和HG在ITSS评分为0和2时有统计学差异(p = 0.002)。仅星形细胞瘤之间的这种相关性较弱,仅考虑中线以下星形细胞瘤时,这种相关性变得显着(p = 0.05)。星形细胞瘤(得分0)和胚胎,脉络丛,生殖细胞,松果体和室管膜瘤(得分2)的得分为0和2是一个很强的区分因素(p = 0.001)。没有髓母细胞瘤的得分为0。结论我们的初步ITTS结果显示,小儿脑肿瘤与成人人群的肿瘤有所不同。
更新日期:2020-03-06
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