title: Conventional magnetic resonance imaging in the differentiation between high and low-grade brain tumours in paediatric patients.
abstract: OBJECTIVE
  It has been described that hyperintensity in diffusion-weighted imaging (DWI) correlates with high-grade tumours, and high signal-intensity in T2-weighted (T2w) images identifies low-grade tumours. We aimed to investigate the potential of routine conventional MRI sequences, such as DWI and T2-w, to pre-operatively distinguish between low-grade and high-grade brain tumours in paediatric patients.
  
  
  METHODS
  Two raters, blinded to the histological diagnosis, rated the aspect and signal intensity of MR images (T2w and DWI) from 37 children with newly diagnosed brain tumours. Histological diagnoses included 18 low-grade and 19 high-grade brain tumours.
  
  
  RESULTS
  The inter-rater agreement was 81-95%. High-grade tumours were never hypointense on DWI and low-grade tumours were usually hyperintense on T2w. Specificity was 100% for low-grade tumours and 90% for high-grade tumours. About 95% of the high-grade tumours and about 70% of the low-grade tumours were correctly diagnosed.
  
  
  CONCLUSIONS
  The combination of general morphological aspect of the tumours and signals on T2-w and DWI yield a high accuracy of pre-operative differentiation between low-grade and high-grade paediatric tumours.
authors: Department of Neuroradiology of the Johann Wolfgang Goethe University, Frankfurt/Main, Germany. Electronic address: luciana.porto@kgu.de.
authors: Luciana
authors: L
authors: Porto
authors: Department of Neuroradiology of the Johann Wolfgang Goethe University, Frankfurt/Main, Germany.
authors: Alina
authors: A
authors: Jurcoane
authors: Paediatric Haematology/Oncology Department of the Johann Wolfgang Goethe University, Frankfurt/Main, Germany.
authors: Dirk
authors: D
authors: Schwabe
authors: Department of Neuroradiology of the Johann Wolfgang Goethe University, Frankfurt/Main, Germany.
authors: Elke
authors: E
authors: Hattingen
mesh_terms: D001932:Brain Neoplasms / Q000145:classification / Q000175:diagnosis*; D002648:Child; D038524:Diffusion Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods / Q000592:standards; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D060787:Neoplasm Grading; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016037:Single-Blind Method
keywords: Brain tumours; Children; DWI; MRI; T2