Minh Duc Nguyen
Department of Radiology, Hanoi Medical University, Ha Noi, Vietnam -
Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam -
Minerva Pediatr (Torino). 2024 Apr;76(2):201-207. doi: 10.23736/S2724-5276.21.05955-7. Epub 2021 Apr 2.
The aim of this study was to evaluate the performance of diffusion tensor imaging (DTI) parameters for the distinction between pediatric medulloblastomas and pilocytic astrocytomas.
DTI was performed in 36 patients, who were divided into two groups: group 1 consisted of 26 patients with medulloblastoma, whereas group 2 consisted of 10 patients with pilocytic astrocytoma. The Mann-Whitney U Test was utilized to compare the tumoral fractional anisotropy (tFA) and diffusivity (tMD) values and the tumor to parenchyma ratios for these values (rFA and rMD, respectively) between these two groups. Receiver operating characteristic (ROC) curve analysis and the Youden Index were applied to compute the cut-off point, and then the area under the curve (AUC), sensitivity, and specificity were calculated.
The tFA and rFA values of group 1 were significantly higher than those of group 2 (P<0.05). In contrast, the tMD and rMD values of group 1 were significantly lower than those of group 2 (P<0.05). Among the FA parameters, a cut-off tFA value of 0.37 provided the best ability to discriminate between medulloblastomas and pilocytic astrocytomas, producing a sensitivity value of 84.6%, a specificity of 80%, and an AUC of 81.7%. The cut-off values for MD and rMD were determined to be 1.06 × 10 mm/s and 1.33, respectively, and were determined to be the most efficacious parameters for the differential diagnosis between medulloblastoma and pilocytic astrocytoma, which generated sensitivity, specificity, and AUC values of 100%.
DTI parameters can play pivotal roles in the discrimination between medulloblastoma and pilocytic astrocytoma.
本研究的目的是评估扩散张量成像（DTI）参数在区分儿童髓母细胞瘤和毛细胞型星形细胞瘤方面的性能。
对36例患者进行了DTI检查，这些患者被分为两组：第1组由26例髓母细胞瘤患者组成，而第2组由10例毛细胞型星形细胞瘤患者组成。采用曼-惠特尼U检验比较两组之间的肿瘤各向异性分数（tFA）和扩散率（tMD）值以及这些值的肿瘤与实质比率（分别为rFA和rMD）。应用受试者工作特征（ROC）曲线分析和尤登指数计算临界值，然后计算曲线下面积（AUC）、敏感性和特异性。
第1组的tFA和rFA值显著高于第2组（P<0.05）。相反，第1组的tMD和rMD值显著低于第2组（P<0.05）。在FA参数中，临界tFA值为0.37时，对髓母细胞瘤和毛细胞型星形细胞瘤的鉴别能力最佳，敏感性值为84.6%，特异性为80%，AUC为81.7%。MD和rMD的临界值分别确定为1.06×10⁻³mm²/s和1.33，并且被确定为髓母细胞瘤和毛细胞型星形细胞瘤鉴别诊断中最有效的参数，其敏感性、特异性和AUC值均为100%。
DTI参数在髓母细胞瘤和毛细胞型星形细胞瘤的鉴别中可发挥关键作用。
