, Volume 60, Issue 1, pp 89–99 | Cite as

T2*-based MR imaging (gradient echo or susceptibility-weighted imaging) in midline and off-midline intracranial germ cell tumors: a pilot study

  • Giovanni MoranaEmail author
  • Cesar Augusto Alves
  • Domenico Tortora
  • Jonathan L. Finlay
  • Mariasavina Severino
  • Paolo Nozza
  • Marcello Ravegnani
  • Marco Pavanello
  • Claudia Milanaccio
  • Mohamad Maghnie
  • Andrea Rossi
  • Maria Luisa Garrè
Paediatric Neuroradiology



The role of T2*-based MR imaging in intracranial germ cell tumors (GCTs) has not been fully elucidated. The aim of this study was to evaluate the susceptibility-weighted imaging (SWI) or T2* gradient echo (GRE) features of germinomas and non-germinomatous germ cell tumors (NGGCTs) in midline and off-midline locations.


We retrospectively evaluated all consecutive pediatric patients referred to our institution between 2005 and 2016, for newly diagnosed, treatment-naïve intracranial GCT, who underwent MRI, including T2*-based MR imaging (T2* GRE sequences or SWI). Standard pre- and post-contrast T1- and T2-weighted imaging characteristics along with T2*-based MR imaging features of all lesions were evaluated. Diagnosis was performed in accordance with the SIOP CNS GCT protocol criteria.


Twenty-four subjects met the inclusion criteria (17 males and 7 females). There were 17 patients with germinomas, including 5 basal ganglia primaries, and 7 patients with secreting NGGCT.

All off-midline germinomas presented with SWI or GRE hypointensity; among midline GCT, all NGGCTs showed SWI or GRE hypointensity whereas all but one pure germinoma were isointense or hyperintense to normal parenchyma. A significant difference emerged on T2*-based MR imaging among midline germinomas, NGGCTs, and off-midline germinomas (p < 0.001).


Assessment of the SWI or GRE characteristics of intracranial GCT may potentially assist in differentiating pure germinomas from NGGCT and in the characterization of basal ganglia involvement. T2*-based MR imaging is recommended in case of suspected intracranial GCT.


SWI Germinoma Germ cell tumors NGGCT Gradient echo Brain tumor 


Compliance with ethical standards


No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

For this type of study formal consent is not required.

Informed consent

For this type of retrospective study formal consent is not required; however, informed consent was obtained from all individual participants included in the study or their legal guardians, and patient assent was obtained whenever appropriate.

Supplementary material

234_2017_1947_MOESM1_ESM.docx (329 kb)
ESM 1 (DOCX 328 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Giovanni Morana
    • 1
    Email author
  • Cesar Augusto Alves
    • 2
  • Domenico Tortora
    • 1
  • Jonathan L. Finlay
    • 3
  • Mariasavina Severino
    • 1
  • Paolo Nozza
    • 4
  • Marcello Ravegnani
    • 5
  • Marco Pavanello
    • 5
  • Claudia Milanaccio
    • 6
  • Mohamad Maghnie
    • 7
  • Andrea Rossi
    • 1
  • Maria Luisa Garrè
    • 6
  1. 1.Neuroradiology UnitIstituto Giannina GasliniGenoaItaly
  2. 2.Radiology DepartmentHospital Das ClinicasSao PauloBrazil
  3. 3.Division of Hematology, Oncology and BMTNationwide Children’s Hospital and The Ohio State UniversityColumbusUSA
  4. 4.Pathology UnitIstituto Giannina GasliniGenoaItaly
  5. 5.Neurosurgery UnitIstituto Giannina GasliniGenoaItaly
  6. 6.Neuro-oncology UnitIstituto Giannina GasliniGenoaItaly
  7. 7.Pediatric Endocrine UnitIstituto Giannina Gaslini, University of GenovaGenoaItaly

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