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23.03.2019 | Paediatric Neuroradiology

Diagnostic performance of an unenhanced MRI exam for tumor follow-up of the optic pathway gliomas in children

verfasst von: Pierre Marsault, Stéphane Ducassou, Fanny Menut, Pierre Bessou, Marion Havez-Enjolras, Jean-François Chateil

Erschienen in: Neuroradiology | Ausgabe 6/2019

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Abstract

Purpose

Contrast-enhanced MRI (MRI + C) is considered as mandatory for brain tumors follow-up, but gadolinium brain depositions in relation with repeated injections have been reported. The aim of our work was to evaluate the diagnostic performance of an unenhanced MRI examination for the follow-up of optic pathway gliomas (OPG) in children.

Methods

Seventeen patients (with/without NF1) were selected from 2001 to 2017, with at least 5 MRI + C brain follow-up examinations. Privacy and data protection rights were addressed by the data protection officer (DPO) and the study was in accordance with the local ethical rules. Twenty-five cases of tumor progression and 25 cases of tumor stability mentioned in the conclusion of radiological reports (defined as gold standard) were isolated. Those exams were anonymized and independently reviewed by two radiologists, who analyzed both quantitative (such as tumor volume variation) and qualitative criteria (such as ventricular dilatation) on unenhanced images. Sensitivity, specificity, positive/negative predictive values (PPV, NPV), and inter/intra-observer agreement were calculated.

Results

The mean age of patients was 5.4 ± 3.4 years and mean follow-up length 6.7 years. The mean number of MRI + C was 13.5 (SD 7.2). The sensitivity of unenhanced MRI for tumor follow-up was 84–88% (95% CI 63.9–97.5). The specificity was 91.3–100% (95% CI 72–100). The PPV was 91.7% for reader 1 and 100% for reader 2. The NVP was 87.5% for reader 1 and 85.2% for reader 2. There was an excellent inter-observer agreement regarding tumor progression: kappa coefficient of 0.87 (p < 0.001). Inter/intra-variability for percentage of tumor volume variation between two exams were good (correlation coefficients of 0.97 and 0.94).

Conclusion

Tumor volume variation is in most cases sufficient to assess OPG progression. Systematic MRI + C could be questionable.

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Titel: Diagnostic performance of an unenhanced MRI exam for tumor follow-up of the optic pathway gliomas in children
verfasst von: Pierre Marsault
Stéphane Ducassou
Fanny Menut
Pierre Bessou
Marion Havez-Enjolras
Jean-François Chateil
Publikationsdatum: 23.03.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Neuroradiology / Ausgabe 6/2019
Print ISSN: 0028-3940
Elektronische ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-019-02198-w

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