Japanese Journal of Radiology

, Volume 34, Issue 9, pp 620–624 | Cite as

Diffusion weighted imaging in differentiating malignant and benign neuroblastic tumors

  • Halil Ibrahim Serin
  • Sureyya Burcu Gorkem
  • Selim Doganay
  • Saliha Cıracı
  • Ekrem Unal
  • Mahmut Guzel
  • Ahmet Kucuk
  • Ali Kurtsoy
  • Abdulhakim Coskun
Original Article



Our aim was to assess diffusion weighted imaging (DWI) of neuroblastic tumors and whether apparent diffusion coefficient (ADC) value may have a role in discrimination among neuroblastoma, ganglioneuroblastoma and ganglioneuroma.

Material and methods

The DWIs (b = 0–800 s/mm2) of 24 children (13 girls, 11 boys) who were diagnosed neuroblastic tumors on histopathological examination (neuroblastoma = 15, ganglioneuroblastoma = 5, ganglioneuroma = 4) were evaluated retrospectively. The ADC maps were performed by drawing freehand ROI on PACS (Sectra Workstation IDS7, Linköping, Sweden).


We observed a significant decrease in ADC value of neuroblastomas 0.869 ± 0.179 × 10−3 mm2/s compared to ganglioneuroblastomas 0.97 ± 0.203 × 10−3 mm2/s and ganglioneuromas 1.147 ± 0.299 × 10−3 mm2/s (p = 0.026). There was no significant difference in between ganglioneuroblastoma and ganglioneuroma (p = 0.16). In detecting neuroblastomas; the sensitivity, specificity, negative and positive predictive values of ADC were 74, 67, 78.6, 66 % respectively with a cut-off value of 0.93 × 10−3 mm2/s.


Our study stands out as the most comprehensive study with larger sample size on this topic. Moreover, we are able to suggest a cut-off value which can discriminate neuroblastoma from ganglioneuroblastoma and ganglioneuroma. We believe that ADC will evolve to an objective, quantitative measurement in discrimination among malignant and benign neuroblastic tumors.


Neuroblastoma Ganglioneuroblastoma Ganglioneuroma DWI ADC 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Topcu S, Alper A, Gulhan E, Kocyigit O, Tastepe I, Cetin G. Neurogenic tumours of the mediastinum: a report of 60 cases. Can Respir J. 2000;7:261–5.CrossRefPubMedGoogle Scholar
  2. 2.
    Lonergan GJ, Schwab CM, Suarez ES, Carlson CL. Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. RadioGraphics. 2002;22:911–34.CrossRefPubMedGoogle Scholar
  3. 3.
    Nakazono T, White CS, Yamasaki F, Yamaguchi K, Egashira R, Irie H, Kudo S. MRI findings of mediastinal neurogenic tumors. AJR Am J Roentgenol. 2011;197:643–52.CrossRefGoogle Scholar
  4. 4.
    Koh DM, Collins DJ. Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol. 2007;188:1622–35.CrossRefPubMedGoogle Scholar
  5. 5.
    Gahr N, Darge K, Hahn G, Kreher BW, von Buiren M, Uhl M. Diffusion-weighted MRI for differentiation of neuroblastoma and ganglioneuroblastoma/ganglioneuroma. Eur J Radiol. 2011;79:443–6.CrossRefPubMedGoogle Scholar
  6. 6.
    MacKenzie JD, Gonzalez L, Hernandez A, Ruppert K, Jaramillo D. Diffusion-weighted and diffusion tensor imaging for pediatric musculoskeletal disorders. Pediatr Radiol. 2007;37:781–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Abdel Razek AA, Gaballa G, Elhawarey G, Elshafey M, Elhadedy T. Characterization of pediatric head and neck masses with diffusion-weighted MR imaging. Eur Radiol. 2009;19:201–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Alibek S, Cavallaro A, Aplas A, Uder M, Staatz G. Diffusion weighted imaging of pediatric and adolescent malignancies with regard to detection and delineation: initial experience. Acad Radiol. 2009;16:866–71.CrossRefPubMedGoogle Scholar
  9. 9.
    Abdel Razek AA, Soliman N, Elashery R. Apparent diffusion coefficient values of mediastinal masses in children. Eur J Radiol. 2011;81:1311–4.CrossRefPubMedGoogle Scholar
  10. 10.
    Kocaoglu M, Bulakbasi N, Sanal HT, et al. Pediatric abdominal masses: diagnostic accuracy of diffusion weighted MRI. Magn Reson Imaging. 2010;28:629–36.CrossRefPubMedGoogle Scholar
  11. 11.
    Uhl M, Altehoefer C, Kontny U, Ilyasov K, Buchert M, Langer M. MRI-diffusion imaging of neuroblastomas: first results and correlation to histology. Eur Radiol. 2002;12:2335–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Demir S, Altinkaya N, Kocer NE, Erbay A, Oguzkurt P. Variations in apparent diffusion coefficient values following chemotherapy in pediatric neuroblastoma. Diagn Interv Radiol. 2015;21:184–8.CrossRefPubMedGoogle Scholar
  13. 13.
    McDonald K, Sebire NJ, Anderson J, Olsen ØE. Patterns of shift in ADC distributions in abdominal tumours during chemotherapy—feasibility study. Pediatr Radiol. 2011;41:99–106.CrossRefPubMedGoogle Scholar
  14. 14.
    Humphries PD, Sebire NJ, Siegel MJ, Olsen ØE. Tumors in pediatric patients at diffusion-weighted MR imaging: apparent diffusion coefficient and tumor cellularity. Radiology. 2007;245:848–54.CrossRefPubMedGoogle Scholar
  15. 15.
    Boubaker A, Delaloye AB. MIBG scintigraphy for the diagnosis and follow-up of children with neuroblastoma. Q J Nucl Med Mol Imaging. 2008;52:388–402.PubMedGoogle Scholar

Copyright information

© Japan Radiological Society 2016

Authors and Affiliations

  • Halil Ibrahim Serin
    • 1
  • Sureyya Burcu Gorkem
    • 2
  • Selim Doganay
    • 2
  • Saliha Cıracı
    • 2
  • Ekrem Unal
    • 3
  • Mahmut Guzel
    • 4
  • Ahmet Kucuk
    • 5
  • Ali Kurtsoy
    • 5
  • Abdulhakim Coskun
    • 2
  1. 1.Department of RadiologyBozok University School of MedicineYozgatTurkey
  2. 2.Department of Radiology, Pediatric Radiology SectionErciyes University School of MedicineKayseriTurkey
  3. 3.Department of OncologyErciyes University School of MedicineKayseriTurkey
  4. 4.Department of Pediatric SurgeryErciyes University School of MedicineKayseriTurkey
  5. 5.Department of NeurosurgeryErciyes University School of MedicineKayseriTurkey

Personalised recommendations