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Diffusion-weighted imaging and the apparent diffusion coefficient on 3T MR imaging in the differentiation of craniopharyngiomas and germ cell tumors

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Abstract

The apparent diffusion coefficient (ADC) on diffusion-weighted imaging (DWI) plays an important role in diagnosing intracranial tumors and predicting the histopathological grade of the tumor. However, the differences in the ADC values between craniopharyngiomas and germ cell tumors (GCTs) have not been clarified. We therefore evaluated the DWI and ADC values at b = 1000 and b = 4000 s/mm2 on 3T magnetic resonance (MR) imaging and assessed the possibility of differentiating between craniopharyngiomas and GCTs. We retrospectively reviewed 19 patients with craniopharyngioma and 24 patients with GCT who underwent surgery and received a histopathological diagnosis. Thirty-four patients underwent DWI with b = 1000 and b = 4000 s/mm2 and nine patients underwent periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) DWI with b = 1000 s/mm2. The ADC was determined by manually placing regions of interests (ROIs) in the respective tumor regions on the ADC maps and is expressed as the minimum (ADCMIN), mean (ADCMEAN), and maximum (ADCMAX) absolute values. The craniopharyngiomas showed lower intensity on DWI at b = 1000 and b = 4000 s/mm2 than the GCTs. Furthermore, the craniopharyngiomas demonstrated significantly high ADC values (ADCMIN, ADCMEAN, and ADCMAX) in comparison with the GCTs on DWI at b = 1000 and b = 4000 s/mm2. The logistic discriminant analysis clarified the advantage of ADCMIN at b = 4000 s/mm2 in differentiating between craniopharyngiomas and GCTs compared with the other ADC values. DWI and the ADC values may help clinicians to differentiate between craniopharyngiomas and GCTs. The ADCMIN at b = 4000 s/mm2 is particularly useful for differentiation.

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Acknowledgments

This study was partially supported by a grant-in-aid from the Japan Society for the Promotion of Science Grant-in Aid for Scientific Research (C) No. 25462262.

Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Yasuyuki Kinoshita, Fumiyuki Yamasaki, Atsushi Tominaga, Satoshi Usui & Kaoru Kurisu

  2. Department of Environmetrics and Biometrics, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Megu Ohtaki

  3. Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan

    Kazunori Arita

  4. Department of Clinical Oncology and Neuro-oncology Program, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Kazuhiko Sugiyama

Authors
  1. Yasuyuki Kinoshita
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  2. Fumiyuki Yamasaki
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  3. Atsushi Tominaga
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  4. Megu Ohtaki
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  5. Satoshi Usui
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  6. Kazunori Arita
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  7. Kazuhiko Sugiyama
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  8. Kaoru Kurisu
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Corresponding author

Correspondence to Yasuyuki Kinoshita.

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Comments

Masahiko Tosaka, Gunma, JAPAN

Diffusion-weighted MR imaging (DWI) is becoming a commonly performed preoperative evaluation to investigate tumor cell density. The authors used periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) DWI as a special MR imaging method to reduce susceptibility artifacts for the preoperative qualitative evaluation of pituitary adenoma and other parasellar tumors in the previous reports. This unique study is an important investigation of the use of PROPELLER DWI for the differential diagnosis of craniopharyngiomas and germ cell tumors (GCTs). GCTs are enhanced well after gadolinium administration and sometimes show cyst formation, rarely with large multilobulated cysts, and sometimes involve calcification. Suprasellar GCTs are rarely misdiagnosed as craniopharyngioma. Papillary craniopharyngiomas including a relatively large solid component and GCTs share some imaging similarities in adult patients. However, craniopharyngioma and GCTs have quite different treatment strategies. The present study indicates that PROPELLER DWI evaluation of tumor cell density may offer important preoperative information for the differentiation of these tumors. Differentiation of pathological subtypes in craniopharyngiomas and GCTs might be the next target of using this special MR imaging method

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Kinoshita, Y., Yamasaki, F., Tominaga, A. et al. Diffusion-weighted imaging and the apparent diffusion coefficient on 3T MR imaging in the differentiation of craniopharyngiomas and germ cell tumors. Neurosurg Rev 39, 207–213 (2016). https://doi.org/10.1007/s10143-015-0660-0

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  • DOI: https://doi.org/10.1007/s10143-015-0660-0

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