{"title":"弥散峰度成像指标在区分脑干胶质瘤和小脑髓母细胞瘤方面的有效性。","authors":"N Minh Duc","doi":"10.7417/CT.2024.5029","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>In some clinical situations, distinguishing between cerebellar medulloblastoma and brainstem glioma is important. We assessed whether diffusion kurtosis imaging (DKI) metrics could be used to distinguish cerebellar medulloblastomas from brainstem gliomas in children.</p><p><strong>Patients and methods: </strong>This prospective study was approved by the institutional review board. Seventy patients were separated into two groups according to eventual diagnosis: brainstem glioma (n = 30) and cerebellar medulloblastoma (n = 40). Both groups underwent brain magnetic resonance imaging (MRI), including DKI. The Kurtosis value for the tumor region and the ratio between Kurtosis values between the tumor and the normal parenchyma (rKurtosis) were compared between groups using the Mann-Whitney U test. Receiver operating characteristic curve analysis and the Youden's Index were applied to identify a cutoff value for distinguishing between the two tumor types, and the area under the curve (AUC), sensitivity, and specificity for the selected cutoff value were calculated.</p><p><strong>Results: </strong>Compared with brainstem gliomas, cerebellar medulloblastomas had significantly higher Kurtosis and rKurtosis values (p < 0.05). Medulloblastoma could be differentiated from brainstem gliomas using a Kurtosis value of 0.91 or an rKurtosis value of 0.90, both of which achieved 100% sensitivity, 96.7% specificity, and AUC values of 0.990.</p><p><strong>Conclusions: </strong>DKI measurements can contribute to distinguishing between cerebellar medulloblastoma and brainstem glioma in children.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The effectiveness of diffusion kurtosis imaging metrics for distinguishing between brainstem glioma and cerebellar medulloblastoma.\",\"authors\":\"N Minh Duc\",\"doi\":\"10.7417/CT.2024.5029\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>In some clinical situations, distinguishing between cerebellar medulloblastoma and brainstem glioma is important. We assessed whether diffusion kurtosis imaging (DKI) metrics could be used to distinguish cerebellar medulloblastomas from brainstem gliomas in children.</p><p><strong>Patients and methods: </strong>This prospective study was approved by the institutional review board. Seventy patients were separated into two groups according to eventual diagnosis: brainstem glioma (n = 30) and cerebellar medulloblastoma (n = 40). Both groups underwent brain magnetic resonance imaging (MRI), including DKI. The Kurtosis value for the tumor region and the ratio between Kurtosis values between the tumor and the normal parenchyma (rKurtosis) were compared between groups using the Mann-Whitney U test. Receiver operating characteristic curve analysis and the Youden's Index were applied to identify a cutoff value for distinguishing between the two tumor types, and the area under the curve (AUC), sensitivity, and specificity for the selected cutoff value were calculated.</p><p><strong>Results: </strong>Compared with brainstem gliomas, cerebellar medulloblastomas had significantly higher Kurtosis and rKurtosis values (p < 0.05). Medulloblastoma could be differentiated from brainstem gliomas using a Kurtosis value of 0.91 or an rKurtosis value of 0.90, both of which achieved 100% sensitivity, 96.7% specificity, and AUC values of 0.990.</p><p><strong>Conclusions: </strong>DKI measurements can contribute to distinguishing between cerebellar medulloblastoma and brainstem glioma in children.</p>\",\"PeriodicalId\":50686,\"journal\":{\"name\":\"Clinica Terapeutica\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinica Terapeutica\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.7417/CT.2024.5029\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinica Terapeutica","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.7417/CT.2024.5029","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
背景:在某些临床情况下,区分小脑延髓母细胞瘤和脑干胶质瘤非常重要。我们评估了弥散峰度成像(DKI)指标是否可用于区分儿童小脑延髓母细胞瘤和脑干胶质瘤:这项前瞻性研究获得了机构审查委员会的批准。70名患者根据最终诊断分为两组:脑干胶质瘤(30人)和小脑髓母细胞瘤(40人)。两组患者均接受了包括 DKI 在内的脑磁共振成像(MRI)检查。采用 Mann-Whitney U 检验比较了组间肿瘤区域的峰度值以及肿瘤与正常实质之间峰度值的比值(rKurtosis)。应用受试者操作特征曲线分析和尤登指数确定区分两种肿瘤类型的临界值,并计算所选临界值的曲线下面积(AUC)、灵敏度和特异性:与脑干胶质瘤相比,小脑髓母细胞瘤的峰度和rKurtosis值明显更高(P < 0.05)。小脑髓母细胞瘤的峰度值为0.91,rKurtosis值为0.90,两者的灵敏度均为100%,特异度为96.7%,AUC值为0.990:DKI测量有助于区分儿童小脑髓母细胞瘤和脑干胶质瘤。
The effectiveness of diffusion kurtosis imaging metrics for distinguishing between brainstem glioma and cerebellar medulloblastoma.
Background: In some clinical situations, distinguishing between cerebellar medulloblastoma and brainstem glioma is important. We assessed whether diffusion kurtosis imaging (DKI) metrics could be used to distinguish cerebellar medulloblastomas from brainstem gliomas in children.
Patients and methods: This prospective study was approved by the institutional review board. Seventy patients were separated into two groups according to eventual diagnosis: brainstem glioma (n = 30) and cerebellar medulloblastoma (n = 40). Both groups underwent brain magnetic resonance imaging (MRI), including DKI. The Kurtosis value for the tumor region and the ratio between Kurtosis values between the tumor and the normal parenchyma (rKurtosis) were compared between groups using the Mann-Whitney U test. Receiver operating characteristic curve analysis and the Youden's Index were applied to identify a cutoff value for distinguishing between the two tumor types, and the area under the curve (AUC), sensitivity, and specificity for the selected cutoff value were calculated.
Results: Compared with brainstem gliomas, cerebellar medulloblastomas had significantly higher Kurtosis and rKurtosis values (p < 0.05). Medulloblastoma could be differentiated from brainstem gliomas using a Kurtosis value of 0.91 or an rKurtosis value of 0.90, both of which achieved 100% sensitivity, 96.7% specificity, and AUC values of 0.990.
Conclusions: DKI measurements can contribute to distinguishing between cerebellar medulloblastoma and brainstem glioma in children.
期刊介绍:
La Clinica Terapeutica è una rivista di Clinica e Terapia in Medicina e Chirurgia, fondata nel 1951 dal Prof. Mariano Messini (1901-1980), Direttore dell''Istituto di Idrologia Medica dell''Università di Roma “La Sapienza”. La rivista è pubblicata come “periodico bimestrale” dalla Società Editrice Universo, casa editrice fondata nel 1945 dal Comm. Luigi Pellino. La Clinica Terapeutica è indicizzata su MEDLINE, INDEX MEDICUS, EMBASE/Excerpta Medica.