Roles of the apparent diffusion coefficient and tumor volume in predicting tumor grade in patients with choroid plexus tumors

Neuroradiology. 2018 May;60(5):479-486. doi: 10.1007/s00234-018-2008-2. Epub 2018 Mar 15.

Abstract

Purpose: To explore the utility of the apparent diffusion coefficient (ADC) and tumor volume to predict histological grade and prognosis in patients with choroid plexus tumors.

Methods: ADC and tumor volumes were retrospectively evaluated in 25 patients with choroid plexus papilloma (CPP; WHO grade 1 [n = 13]), atypical CPP (aCPP; grade 2 [n = 8]), or choroid plexus carcinoma (grade 3 [n = 4]) The prognostic roles of ADC and tumor volume were assessed.

Results: There were significant differences in mean and minimum ADC values, and tumor volume among the WHO grades (p = 0.033, p = 0.044, and p = 0.014, respectively). Receiver-operating characteristic analysis revealed a mean cutoff ADC value ≤ 1.397 × 10-3 mm2/s for aCPP (sensitivity = 0.667, specificity = 0.923). Multiple linear regression analysis demonstrated that both mean ADC (β = - 0.455, p = 0.005) and tumor volume (β = 0.513, p = 0.002) were correlated with WHO grade (adjusted R2 = 0.520, p = 0.005). Kaplan-Meier curve analysis identified poorer survival in patients with WHO grade 2 and 3 tumors than in those with WHO grade 1 disease (p = 0.049 and p = 0.012, respectively). A mean ADC ≤ 1.397 × 10-3 mm2/s (p = 0.001) and tumor volume 21.05 ml (p = 0.031) predicted significantly poorer survival.

Conclusion: Mean ADC and tumor volume were correlated with WHO grade of choroid plexus tumors. A lower ADC value and a larger tumor volume predicted a poorer prognosis.

Keywords: Apparent diffusion coefficient; Choroid plexus carcinoma; Choroid plexus papilloma; Tumor volume.

MeSH terms

  • Adolescent
  • Adult
  • Choroid Plexus Neoplasms / pathology*
  • Diffusion Magnetic Resonance Imaging*
  • Female
  • Humans
  • Male
  • Neoplasm Grading
  • Prognosis
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tumor Burden