title: Prognostic and predictive values of diffusion and perfusion MRI in paediatric intracranial ependymomas in a large national study.
abstract: OBJECTIVE
  To assess the relative cerebral blood volume (rCBV) and apparent diffusion coefficient (ADC) derived, respectively, from perfusion and diffusion pre-operative MRI of intracranial ependymomas and their predictive and prognostic values.
  
  
  METHODS
  Pre-operative MRI and clinical data for intracranial ependymomas diagnosed between January 2000 and December 2013 were retrospectively retrieved from a web-based national database. MRI data included diffusion (62 patients) and perfusion (20 patients) MRI. Patient age, histopathological diagnosis, tumour location, ADC, relative ADC (rADC) and rCBV were considered as potential factors in a survival analysis. Survival rates were estimated using the Kaplan-Meier method. Univariate analyses were performed using the log-rank test to compare groups. We also performed a multivariate analysis, applying the Cox proportional hazards model.
  
  
  RESULTS
  ADC and rADC values within hypointense regions differed significantly between grades II and III (p = 0.01). The 75th percentile of ADC within hypointense regions and the 25th percentile of rCBV within non-enhancing lesions were prognostic of disease-free survival (p = 0.004, p = 0.05). A significant correlation was found between the 75th percentile of rCBV and the 25th percentile of rADC (p = 0.01) in enhancing regions of grade-III tumours.
  
  
  CONCLUSIONS
  Pre-operative rADC and rCBV could be used as prognostic factors for clinical outcome and to predict histological grade in paediatric ependymomas.
  
  
  CONCLUSIONS
  Prognostic value of diffusion and perfusion MRI in paediatric ependymoma was found and may play a role in the prognostic classification of patients in order to design more tailored treatment strategies.
authors.affiliation: 1 Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France.
authors.forename: Fatima
authors.initials: F
authors.lastname: Tensaouti
authors.affiliation: 2 Department of Radiation Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse - Oncopole, Toulouse, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Ducassou
authors.affiliation: 3 Department of Biostatistics, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France.
authors.forename: Léonor
authors.initials: L
authors.lastname: Chaltiel
authors.affiliation: 4 Department of Radiology, CHU Purpan, Toulouse, France.
authors.forename: Annick
authors.initials: A
authors.lastname: Sevely
authors.affiliation: 5 Department of Radiation Oncology, Institut Gustave Roussy, Paris, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Bolle
authors.affiliation: 6 Department of Radiation Oncology, CHU La Timone, Marseille, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Muracciole
authors.affiliation: 7 Department of Radiation Oncology, Centre Oscar Lambret, Lille, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Coche-Dequant
authors.affiliation: 8 Department of Radiation Oncology, Institut Curie, Paris, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Alapetite
authors.affiliation: 9 Department of Radiation Oncology, Institut de cancérologie de l'ouest, Nantes, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Supiot
authors.affiliation: 10 Department of Radiation Oncology, CHU Bordeaux, Bordeaux, France.
authors.forename: Aymeri
authors.initials: A
authors.lastname: Huchet
authors.affiliation: 11 Department of Radiation Oncology, Centre Alexis Vautrin, Vandoeuvre, Nancy, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Bernier
authors.affiliation: 12 Department of Radiation Oncology, Centre Léon Bérard, Lyon, France.
authors.forename: Line
authors.initials: L
authors.lastname: Claude
authors.affiliation: 13 Department of pediatric, Hematology-Oncology Unit, CHU Purpan, Toulouse, France.
authors.forename: Anne-Isabelle
authors.initials: AI
authors.lastname: Bertozzi-Salamon
authors.affiliation: 1 Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France.
authors.forename: Samuel
authors.initials: S
authors.lastname: Liceaga
authors.affiliation: 1 Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France.|14 Department of Nuclear Medicine, CHU Rangueil, Toulouse, France.
authors.forename: Jean Albert
authors.initials: JA
authors.lastname: Lotterie
authors.affiliation: 1 Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France.
authors.forename: Patrice
authors.initials: P
authors.lastname: Péran
authors.affiliation: 1 Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France.|15 Department of Nuclear Medicine, CHU Purpan, Toulouse, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Payoux
authors.affiliation: 1 Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France.|2 Department of Radiation Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse - Oncopole, Toulouse, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Laprie
mesh_terms: D001810:Blood Volume; D001932:Brain Neoplasms / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging; D004806:Ependymoma / Q000000981:diagnostic imaging*; D005260:Female; D005602:France; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate