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Neuroradiology
Published in: Neuroradiology 1/2018

01-01-2018 | Paediatric Neuroradiology

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

Authors: Giovanni Morana, 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

Published in: Neuroradiology | Issue 1/2018

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Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusion

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.
Appendix
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Metadata
Title
T2*-based MR imaging (gradient echo or susceptibility-weighted imaging) in midline and off-midline intracranial germ cell tumors: a pilot study
Authors
Giovanni Morana
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
Publication date
01-01-2018
Publisher
Springer Berlin Heidelberg
Published in
Neuroradiology / Issue 1/2018
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-017-1947-3

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