Imaging diagnosis of basal ganglia germ cell tumors: subtype features subtype imaging features of GCTs

Br J Radiol. 2021 Jun 1;94(1122):20201453. doi: 10.1259/bjr.20201453. Epub 2021 Apr 29.

Abstract

Objectives: To evaluate the subtype imaging features of basal ganglia germ cell tumors (GCTs).

Methods: Clinical and imaging data of 33 basal ganglia GCTs were retrospectively analyzed, including 17 germinomas and 16 mixed germ cell tumors (MGCTs).

Results: The cyst/mass ratio of germinomas (0.53 ± 0.32) was higher than that of MGCTs (0.28 ± 0.19, p = 0.030). CT density of the solid part of germinomas (41.47 ± 5.22 Hu) was significantly higher than that of MGCTs (33.64 ± 3.75 Hu, p < 0.001), while apparent diffusion coefficients (ADC, ×10-3 mm2/s) value of the solid part was significantly lower in geminomas (0.86 ± 0.27 ×10-3 mm2/s) than in MGCTs (1.42 ± 0.39 ×10-3 mm2/s, p < 0.001). MGCTs were more common with intratumoral hemorrhage (68.75% vs 11.76%, p = 0.01), T1 hyperintense foci (68.75% vs 5.88%, p < 0.001) and calcification (64.29% vs 20.00%, p = 0.025) than germinomas. There was no significant difference in internal capsule involvement between the two subtypes (p = 0.303), but Wallerian degeneration was more common in germinomas than in MGCTs (70.59% vs 25.00%, p = 0.015).

Conclusion: The subtypes of GCT have different imaging features. Tumoral cystic-solidity, heterogeneity, ADC value, CT density, and Wallerian degeneration are helpful to differentiate germinomas and MGCTs in basal ganglia.

Advances in knowledge: The subtypes of GCT have different histological characteristics, leading to various imaging findings. The imaging features of GCT subtypes in basal ganglia may aid clinical diagnosis and treatment.

MeSH terms

  • Adolescent
  • Basal Ganglia / diagnostic imaging*
  • Basal Ganglia / pathology
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / pathology
  • Child
  • Contrast Media
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Humans
  • Male
  • Neoplasms, Germ Cell and Embryonal / diagnostic imaging*
  • Neoplasms, Germ Cell and Embryonal / pathology
  • Retrospective Studies
  • Tomography, X-Ray Computed

Substances

  • Contrast Media