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Dysembryoplastic neuroepithelial tumors: proton MR spectroscopy, diffusion and perfusion characteristics

Neuroradiology volume 49, pages 805–812 (2007)Cite this article

Abstract

Introduction

We describe the magnetic resonance (MR) imaging characteristics of dysembryoplastic neuroepithelial tumors (DNT) and discuss their differential diagnosis.

Material and methods

Proton MR spectroscopy (TE 30 and 136 ms), diffusion-weighted and perfusion images were retrospectively evaluated in 22 patients with pathologically proven DNT (17 male and 5 female, mean age 18.7 years) and 14 control subjects (10 male and 4 female, mean age 16.9 years). The results from the DNT patients and from the control subjects were compared using an independent sample t-test and the degree of correlation was tested by Pearson’s correlation.

Results

All DNTs were solitary and in a supratentorial cortical or subcortical location (ten temporal, eight frontal and four parietal). They had low-signal on T1-weighted images and high-signal on T2-weighted images without a prominent mass effect. Additionally a cystic appearance (six patients, 27.3%), cortical dysplasia (six patients, 27.3%) and contrast enhancement (four patients, 18.2%) were also noted. No significant differences were detected in NAA/Cho, NAA/Cr, NAA/Cho+Cr or Cho/Cr ratios between DNT and normal brain. DNTs had a significantly higher mI/Cr ratio and apparent diffusion coefficient (ADC) values and lower cerebral blood values than normal parenchyma (P < 0.001). ADC had the highest correlation with the diagnosis of DNT (r = 0.996) followed by relative cerebral blood volume (rCBV) (r = −0.883) and mI/Cr ratio (r = 0.663).

Conclusion

Proton MR spectroscopy, diffusion-weighted and perfusion imaging characteristics of DNTs provide additional information to their MR imaging findings. The MR spectrum showing a slight increase in mI/Cr ratio, and higher ADC and lower rCBV values than normal parenchyma help to differentiate DNTs from other cortical tumors, which had higher rCBV and lower ADC values than DNTs.

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References

  1. Daumas-Duport C, Pietsch T, Lantos PL (2000) Dysembryoplastic neuroepithelial tumour. In: Kleihues P, Cavenee WK (eds) WHO classification of tumours: pathology and genetics of tumours of the nervous system. IARC, Lyon, pp 103–106

    Google Scholar 

  2. Daumas-Duport C, Scheithauer BW, Chodkiewicz JP, Laws ER Jr, Vedrenne C (1988) Dysembryoplastic neuroepithelial tumor: a surgically curable tumor of young patients with intractable partial seizures. Report of thirty-nine cases. Neurosurgery 23:545–556

    PubMed  Article  CAS  Google Scholar 

  3. Stanescu Cosson R, Varlet P, Beuvon F, Daumas Duport C, Devaux B, Chassoux F, Fredy D, Meder JF (2001) Dysembryoplastic neuroepithelial tumors: CT, MR findings and imaging follow-up: a study of 53 cases. J Neuroradiol 28:230–240

    PubMed  CAS  Google Scholar 

  4. Fernandez C, Girard N, Paz Paredes A, Bouvier-Labit C, Lena G, Figarella-Branger D (2003) The usefulness of MR imaging in the diagnosis of dysembryoplastic neuroepithelial tumor in children: a study of 14 cases. AJNR Am J Neuroradiol 24:829–834

    PubMed  Google Scholar 

  5. Koeller KK, Dillon WP (1992) Dysembryoplastic neuroepithelial tumors: MR appearance. AJNR Am J Neuroradiol 13:1319–1325

    PubMed  CAS  Google Scholar 

  6. Guesmi H, Houtteville JP, Courtheoux P, Derlon JM, Chapon F (1999) Dysembryoplastic neuroepithelial tumors. Report of 8 cases including two with unusual localization. Neurochirurgie 45:190–200

    PubMed  CAS  Google Scholar 

  7. Baisden BL, Brat DJ, Melhem ER, Rosenblum MK, King AP, Burger PC (2001) Dysembryoplastic neuroepithelial tumor-like neoplasm of the septum pellucidum: a lesion often misdiagnosed as glioma: report of 10 cases. Am J Surg Pathol 25:494–499

    PubMed  Article  CAS  Google Scholar 

  8. Cervera-Pierot P, Varlet P, Chodkiewicz JP, Daumas-Duport C (1997) Dysembryoplastic neuroepithelial tumors located in the caudate nucleus area: report of four cases. Neurosurgery 40:1065–1069

    PubMed  Article  CAS  Google Scholar 

  9. Lee MC, Kang JY, Seol MB, Kim HS, Woo JY, Lee JS, Jung S, Kim JH, Woo YJ, Kim MK, Kim HI, Kim SU (2006) Clinical features and epileptogenesis of dysembryoplastic neuroepithelial tumor. Childs Nerv Syst 22:1611–1618

    PubMed  Article  Google Scholar 

  10. Raybaud C, Shroff M, Rutka JT, Chuang SH (2006) Imaging surgical epilepsy in children. Childs Nerv Syst 22:786–809

    PubMed  Article  Google Scholar 

  11. Chan CH, Bittar RG, Davis GA, Kalnins RM, Fabinyi GC (2006) Long-term seizure outcome following surgery for dysembryoplastic neuroepithelial tumor. J Neurosurg 104:62–69

    PubMed  Article  Google Scholar 

  12. Kuroiwa T, Kishikawa T, Kato A, Ueno M, Kudo S, Tabuchi K (1994) Dysembryoplastic neuroepithelial tumors: MR findings. J Comput Assist Tomogr 18:352–356

    PubMed  Article  CAS  Google Scholar 

  13. Kimura S, Kobayashi T, Hara M (1996) A case of dysembryoplastic neuroepithelial tumor of the parietal lobe with characteristic magnetic resonance imaging. Acta Paediatr Jpn 38:168–171

    PubMed  CAS  Google Scholar 

  14. Lee DY, Chung CK, Hwang YS, Choe G, Chi JG, Kim HJ, Cho BK (2000) Dysembryoplastic neuroepithelial tumor: radiological findings (including PET, SPECT, and MRS) and surgical strategy. J Neurooncol 47:167–174

    PubMed  Article  CAS  Google Scholar 

  15. Ostertun B, Wolf HK, Campos MG, Matus C, Solymosi L, Elger CE, Schramm J, Schild HH (1996) Dysembryoplastic neuroepithelial tumors: MR and CT evaluation. AJNR Am J Neuroradiol 17:419–430

    PubMed  CAS  Google Scholar 

  16. Jensen RL, Caamano E, Jensen EM, Couldwell WT (2006) Development of contrast enhancement after long-term observation of a dysembryoplastic neuroepithelial tumor. J Neurooncol 78:59–62

    PubMed  Article  Google Scholar 

  17. Sherburn EW, Bahn MM, Gokden M, Silbergeld DL, Rich KM (1998) Dysembryoplastic neuroepithelial tumor and oligodendroglioma: the diagnostic value of magnetic resonance spectroscopy. Case report and review of the literature. Neurosurg Focus 4(4):e6

    PubMed  CAS  Google Scholar 

  18. Rushing EJ, Thompson LD, Mena H (2003) Malignant transformation of a dysembryoplastic neuroepithelial tumor after radiation and chemotherapy. Ann Diagn Pathol 7:240–244

    PubMed  Article  Google Scholar 

  19. Bulakbasi N, Kocaoglu M, Ors F, Tayfun C, Ucoz T (2003) Combination of single voxel proton MR spectroscopy and apparent diffusion coefficients calculation in the evaluation of common brain tumors. AJNR Am J Neuroradiology 24:225–233

    Google Scholar 

  20. Vuori K, Kankaanranta L, Hakkinen AM, Gaily E, Valanne L, Granstrom ML, Joensuu H, Blomstedt G, Paetau A, Lundbom N (2004) Low-grade gliomas and focal cortical developmental malformations: differentiation with proton MR spectroscopy. Radiology 230:703–708

    PubMed  Article  Google Scholar 

  21. Wang L, Li K, Chen L, Lu D, Zhang G, Li Y (2005) Perfusion MR imaging and proton MR spectroscopy in a case of dysembryoplastic neuroepithelial tumor. Chin Med J (Engl) 118:1134–1136

    Google Scholar 

  22. Takahashi A, Hong SC, Seo DW, Hong SB, Lee M, Suh YL (2005) Frequent association of cortical dysplasia in dysembryoplastic neuroepithelial tumor treated by epilepsy surgery. Surg Neurol 64:419–427

    PubMed  Article  Google Scholar 

  23. Pierce GB (1983) The cancer cell and its control by the embryo. Rous-Whipple Award lecture. Am J Pathol 113:117–124

    PubMed  CAS  Google Scholar 

  24. Di Costanzo A, Scarabino T, Trojsi F, Giannatempo GM, Popolizio T, Catapano D, Bonavita S, Maggialetti N, Tosetti M, Salvolini U, d’Angelo VA, Tedeschi G (2006) Multiparametric 3T MR approach to the assessment of cerebral gliomas: tumor extent and malignancy. Neuroradiology 48:622–631

    PubMed  Article  Google Scholar 

  25. Rollin N, Guyotat J, Streichenberger N, Honnorat J, Tran Minh VA, Cotton F (2006) Clinical relevance of diffusion and perfusion magnetic resonance imaging in assessing intra-axial brain tumors. Neuroradiology 48:150–159

    PubMed  Article  CAS  Google Scholar 

  26. Knopp EA, Cha S, Johnson G, Mazumdar A, Golfinos JG, Zagzag D, Miller DC, Kelly PJ, Kricheff II (1999) Glial neoplasms: dynamic contrast enhanced T2*-weighted MR imaging. Radiology 211:791–798

    PubMed  CAS  Google Scholar 

  27. Law M, Yang S, Wang H, Babb JS, Johnson G, Cha S, Knopp EA, Zagzag D (2003) Glioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging. AJNR Am J Neuroradiol 24:1989–1998

    PubMed  Google Scholar 

  28. Aronen HJ, Gazit IE, Louis DN, Buchbinder BR, Pardo FS, Weisskoff RM, Harsh GR, Cosgrove GR, Halpern EF, Hochberg FH, Rosen BR (1994) Cerebral blood volume maps of gliomas: comparison with tumor grade and histologic findings. Radiology 191:41–51

    PubMed  CAS  Google Scholar 

  29. Yang D, Korogi Y, Sugahara T, Kitajima M, Shigematsu Y, Liang L, Ushio Y, Takahashi M (2002) Cerebral gliomas: prospective comparison of multivoxel 2D chemical-shift imaging proton MR spectroscopy, echoplanar perfusion and diffusion-weighted MRI. Neuroradiology 44:656–666

    PubMed  Article  CAS  Google Scholar 

  30. Castillo M, Smith JK, Kwock L (2000) Correlation of myo-inositol levels and grading of cerebral astrocytoma. AJNR Am J Neuroradiol 21:1645–1649

    PubMed  CAS  Google Scholar 

  31. Cha S (2006) Update on brain tumor imaging: from anatomy to physiology. AJNR Am J Neuroradiol 27:475–487

    PubMed  CAS  Google Scholar 

  32. Kim JH, Chang KH, Na DG, Song IC, Kwon BJ, Han MH, Kim K (2006) 3T 1H-MR spectroscopy in grading of cerebral gliomas: comparison of short and intermediate echo time sequences. AJNR Am J Neuroradiol 27:1412–1418

    PubMed  Google Scholar 

  33. Chiang IC, Kuo YT, Lu CY, Yeung KW, Lin WC, Sheu FO, Liu GC (2004) Distinction between high-grade gliomas and solitary metastases using peritumoral 3-T magnetic resonance spectroscopy, diffusion, and perfusion imagings. Neuroradiology 46:619–627

    PubMed  Article  Google Scholar 

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Conflict of interest statement

We declare that we have no conflict of interest.

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Affiliations

  1. Department of Radiology, Military Medical Faculty, Gulhane Military Medical Academy, Etlik, 06018, Ankara, Turkey

    Nail Bulakbasi, Murat Kocaoglu, Tuba H. Sanal & Cem Tayfun

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  1. Nail Bulakbasi
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  2. Murat Kocaoglu
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  4. Cem Tayfun
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Correspondence to Nail Bulakbasi.

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Bulakbasi, N., Kocaoglu, M., Sanal, T.H. et al. Dysembryoplastic neuroepithelial tumors: proton MR spectroscopy, diffusion and perfusion characteristics. Neuroradiology 49, 805–812 (2007). https://doi.org/10.1007/s00234-007-0263-8

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Keywords

  • Dysembryoplastic neuroepithelial tumors
  • Proton MR spectroscopy
  • Diffusion-weighted imaging
  • Perfusion imaging
  • Magnetic resonance imaging