Apparent Diffusion Coefficients in Evaluation of
Pediatric Brain Tumors
Lojana Tuntiyatorn MD*, Bordin Nantawas MD*,
Nongnuch Sirachainan MD**, Nopadol Larbcharoensub MD***,
Anannit Visudtibhan MD****, Suradej Hongeng MD**
Affiliation :
* Division of Neuroradiology, Department of Radiology, Faculty of Medicine, Ramathibodi Hospital,
Mahidol University, Bangkok, Thailand
** Division of Oncology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital,
Mahidol University, Bangkok, Thailand
*** Division of Neuropathology, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital,
Mahidol University, Bangkok, Thailand
**** Division of Neurology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital,
Mahidol University, Bangkok, Thailand
Background : MRI, which has high sensitivity in brain tumor detection, cannot reliably determine tumor grading or histology.
Diffusion-weighted imaging and apparent diffusion coefficients (ADCs) provide information of tumor cellularity that can
correlate with grading.
Objective : To investigate ADCs in differentiation low-grade from high-grade pediatric brain tumors.
Material and Method: Preoperative MRI, DWI, and ADC images of pediatric patients with pathologically proven brain
tumors were retrospectively reviewed at a university hospital in two-year periods and classified into low-grade and high-
grade categories. Regions of interest were placed manually at the center and periphery of the solid tumor regions, then
ADC values were calculated at “b” values = 0, 1000 sec/mm2.
Results : The ADC values were calculated in 15 patients, which included 12 males and three females with an age range
from three to 14 years. Seven and eight were with low- and high-grade tumors respectively. The ADC values of low-grade
tumors were markedly higher than those of high-grade tumors with statistically significant differences by all methods of
measurements at the central, peripheral, and average areas on Man-Whitney U test, with p-values of 0.037, 0.009, and
0.021, respectively.
Conclusion : MRI with ADCs for preoperative pediatric tumor evaluation may be useful for predicting tendency of tumor
grading and surgical planning.
Keywords : Apparent diffusion coefficients, Pediatric, Brain tumor
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