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Pediatric Radiology
Published in: Pediatric Radiology 7/2013

01-07-2013 | Original Article

Role of diffusion-weighted imaging in differentiating benign and malignant pediatric abdominal tumors

Authors: Rakhee S. Gawande, Gabriel Gonzalez, Solomon Messing, Aman Khurana, Heike E. Daldrup-Link

Published in: Pediatric Radiology | Issue 7/2013

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Abstract

Background

Solid malignant tumors are more highly cellular than benign lesions and hence have a restricted diffusion of water molecules.

Objective

To evaluate whether diffusion-weighted MR imaging (DWI) can differentiate between benign and malignant pediatric abdominal tumors.

Materials and methods

We retrospectively analyzed DWI scans of 68 consecutive children with 39 benign and 34 malignant abdominal masses. To calculate the apparent diffusion coefficient (ADC) maps and ADC values, we used 1.5-T sequences at TR/TE/b-value of 5,250–7,500/54–64/b = 0, 500 and 3-T sequences at 3,500–4,000/66–73/b = 0, 500, 800. ADC values were compared between benign and malignant and between data derived at 1.5 tesla (T) and at 3 tesla magnetic field strength, using the Mann-Whitney-Wilcoxon test, ANOVA and a receiver operating curve (ROC) analysis.

Results

There was no significant difference in ADC values obtained at 1.5 T and 3 T (P = 0.962). Mean ADC values (× 10−3 mm2/s) were 1.07 for solid malignant tumors, 1.6 for solid benign tumors, 2.9 for necrotic portions of malignant tumors and 3.1 for cystic benign lesions. The differences between malignant and benign solid tumors were statistically significant (P = 0.000025). ROC analysis revealed an optimal cut-off ADC value for differentiating malignant and benign solid tumors as 1.29 with excellent inter-observer reliability (alpha score 0.88).

Conclusion

DWI scans and ADC values can contribute to distinguishing between benign and malignant pediatric abdominal tumors.
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Metadata
Title
Role of diffusion-weighted imaging in differentiating benign and malignant pediatric abdominal tumors
Authors
Rakhee S. Gawande
Gabriel Gonzalez
Solomon Messing
Aman Khurana
Heike E. Daldrup-Link
Publication date
01-07-2013
Publisher
Springer-Verlag
Published in
Pediatric Radiology / Issue 7/2013
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-013-2626-0

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