title: Diffusion weighted imaging in differentiating malignant and benign neuroblastic tumors.
abstract: OBJECTIVE
  Our aim was to assess diffusion weighted imaging (DWI) of neuroblastic tumors and whether apparent diffusion coefficient (ADC) value may have a role in discrimination among neuroblastoma, ganglioneuroblastoma and ganglioneuroma.
  
  
  METHODS
  The DWIs (b = 0-800 s/mm(2)) of 24 children (13 girls, 11 boys) who were diagnosed neuroblastic tumors on histopathological examination (neuroblastoma = 15, ganglioneuroblastoma = 5, ganglioneuroma = 4) were evaluated retrospectively. The ADC maps were performed by drawing freehand ROI on PACS (Sectra Workstation IDS7, Linköping, Sweden).
  
  
  RESULTS
  We observed a significant decrease in ADC value of neuroblastomas 0.869 ± 0.179 × 10(-3) mm(2)/s compared to ganglioneuroblastomas 0.97 ± 0.203 × 10(-3) mm(2)/s and ganglioneuromas 1.147 ± 0.299 × 10(-3) mm(2)/s (p = 0.026). There was no significant difference in between ganglioneuroblastoma and ganglioneuroma (p = 0.16). In detecting neuroblastomas; the sensitivity, specificity, negative and positive predictive values of ADC were 74, 67, 78.6, 66 % respectively with a cut-off value of 0.93 × 10(-3) mm(2)/s.
  
  
  CONCLUSIONS
  Our study stands out as the most comprehensive study with larger sample size on this topic. Moreover, we are able to suggest a cut-off value which can discriminate neuroblastoma from ganglioneuroblastoma and ganglioneuroma. We believe that ADC will evolve to an objective, quantitative measurement in discrimination among malignant and benign neuroblastic tumors.
authors.affiliation: Department of Radiology, Bozok University School of Medicine, Yozgat, Turkey. raddrhiserin@gmail.com.
authors.forename: Halil Ibrahim
authors.initials: HI
authors.lastname: Serin
authors.affiliation: Department of Radiology, Pediatric Radiology Section, Erciyes University School of Medicine, Melikgazi, Kayseri, Turkey. drburcugorkem@gmail.com.
authors.forename: Sureyya Burcu
authors.initials: SB
authors.lastname: Gorkem
authors.affiliation: Department of Radiology, Pediatric Radiology Section, Erciyes University School of Medicine, Melikgazi, Kayseri, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Doganay
authors.affiliation: Department of Radiology, Pediatric Radiology Section, Erciyes University School of Medicine, Melikgazi, Kayseri, Turkey.
authors.forename: Saliha
authors.initials: S
authors.lastname: Cıracı
authors.affiliation: Department of Oncology, Erciyes University School of Medicine, Melikgazi, Kayseri, Turkey.
authors.forename: Ekrem
authors.initials: E
authors.lastname: Unal
authors.affiliation: Department of Pediatric Surgery, Erciyes University School of Medicine, Melikgazi, Kayseri, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Guzel
authors.affiliation: Department of Neurosurgery, Erciyes University School of Medicine, Melikgazi, Kayseri, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kucuk
authors.affiliation: Department of Neurosurgery, Erciyes University School of Medicine, Melikgazi, Kayseri, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Kurtsoy
authors.affiliation: Department of Radiology, Pediatric Radiology Section, Erciyes University School of Medicine, Melikgazi, Kayseri, Turkey.
authors.forename: Abdulhakim
authors.initials: A
authors.lastname: Coskun
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005729:Ganglioneuroma / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009447:Neuroblastoma / Q000000981:diagnostic imaging*; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: ADC; DWI; Ganglioneuroblastoma; Ganglioneuroma; Neuroblastoma