A Diagnostic Algorithm for Posterior Fossa Tumors in Children: A Validation Study
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.3174/ajnr.A7057 http://hdl.handle.net/11449/210428 |
Resumo: | BACKGROUND AND PURPOSE: Primary posterior fossa tumors comprise a large group of neoplasias with variable aggressiveness and short and long-term outcomes. This study aimed to validate the clinical usefulness of a radiologic decision flow chart based on previously published neuroradiologic knowledge for the diagnosis of posterior fossa tumors in children. MATERIALS AND METHODS: A retrospective study was conducted (from January 2013 to October 2019) at 2 pediatric referral centers, Children?s Hospital of Philadelphia, United States, and Great Ormond Street Hospital, United Kingdom. Inclusion criteria were younger than 18 years of age and histologically and molecularly confirmed posterior fossa tumors. Subjects with no available preoperative MR imaging and tumors located primarily in the brain stem were excluded. Imaging characteristics of the tumors were evaluated following a predesigned, step-by-step flow chart. Agreement between readers was tested with the Cohen ?, and each diagnosis was analyzed for accuracy. RESULTS: A total of 148 cases were included, with a median age of 3.4?years (interquartile range, 2.1?6.1 years), and a male/female ratio of 1.24. The predesigned flow chart facilitated identification of pilocytic astrocytoma, ependymoma, and medulloblastoma sonic hedgehog tumors with high sensitivity and specificity. On the basis of the results, the flow chart was adjusted so that it would also be able to better discriminate atypical teratoid/rhabdoid tumors and medulloblastoma groups 3 or 4 (sensitivity = 75%?79%; specificity = 92%?99%). Moreover, our adjusted flow chart was useful in ruling out ependymoma, pilocytic astrocytomas, and medulloblastoma sonic hedgehog tumors. CONCLUSIONS: The modified flow chart offers a structured tool to aid in the adjunct diagnosis of pediatric posterior fossa tumors. Our results also establish a useful starting point for prospective clinical studies and for the development of automated algorithms, which may provide precise and adequate diagnostic tools for these tumors in clinical practice. |
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A Diagnostic Algorithm for Posterior Fossa Tumors in Children: A Validation StudyBACKGROUND AND PURPOSE: Primary posterior fossa tumors comprise a large group of neoplasias with variable aggressiveness and short and long-term outcomes. This study aimed to validate the clinical usefulness of a radiologic decision flow chart based on previously published neuroradiologic knowledge for the diagnosis of posterior fossa tumors in children. MATERIALS AND METHODS: A retrospective study was conducted (from January 2013 to October 2019) at 2 pediatric referral centers, Children?s Hospital of Philadelphia, United States, and Great Ormond Street Hospital, United Kingdom. Inclusion criteria were younger than 18 years of age and histologically and molecularly confirmed posterior fossa tumors. Subjects with no available preoperative MR imaging and tumors located primarily in the brain stem were excluded. Imaging characteristics of the tumors were evaluated following a predesigned, step-by-step flow chart. Agreement between readers was tested with the Cohen ?, and each diagnosis was analyzed for accuracy. RESULTS: A total of 148 cases were included, with a median age of 3.4?years (interquartile range, 2.1?6.1 years), and a male/female ratio of 1.24. The predesigned flow chart facilitated identification of pilocytic astrocytoma, ependymoma, and medulloblastoma sonic hedgehog tumors with high sensitivity and specificity. On the basis of the results, the flow chart was adjusted so that it would also be able to better discriminate atypical teratoid/rhabdoid tumors and medulloblastoma groups 3 or 4 (sensitivity = 75%?79%; specificity = 92%?99%). Moreover, our adjusted flow chart was useful in ruling out ependymoma, pilocytic astrocytomas, and medulloblastoma sonic hedgehog tumors. CONCLUSIONS: The modified flow chart offers a structured tool to aid in the adjunct diagnosis of pediatric posterior fossa tumors. Our results also establish a useful starting point for prospective clinical studies and for the development of automated algorithms, which may provide precise and adequate diagnostic tools for these tumors in clinical practice.Childrens Hosp Philadelphia, Div Neuroradiol, Dept Radiol, 3401 Civ Ctr Blvd, Philadelphia, PA 19104 USAUCL, Great Ormond St Hosp Children, Dept Radiol, London, EnglandUCL, Great Ormond St Hosp Children, Dept Neurosurg, London, EnglandSao Paulo State Univ, Dept Biostat, Inst Biociencias, Sao Paulo, BrazilUCL, Great Ormond St Inst Child Hlth, Dev Biol & Canc Programme, London, EnglandHosp Clin Sao Paulo, Fac Med Sao Paulo, Dept Radiol, Sao Paulo, BrazilSao Paulo State Univ, Dept Biostat, Inst Biociencias, Sao Paulo, BrazilAmer Soc NeuroradiologyChildrens Hosp PhiladelphiaUCLUniversidade Estadual Paulista (Unesp)Universidade de São Paulo (USP)Alves, C. A. P. F.Lobel, U.Martin-Saavedra, J. S.Toescu, S.Tsunemi, M. H. [UNESP]Teixeira, S. R.Mankad, K.Hargrave, D.Jacques, T. S.Costa Leite, C. daGoncalves, F. G.Vossough, A.D'Arco, F.2021-06-25T15:20:19Z2021-06-25T15:20:19Z2021-03-04info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article961-968http://dx.doi.org/10.3174/ajnr.A7057American Journal Of Neuroradiology. Denville: Amer Soc Neuroradiology, v. 42, n. 5, p. 961-968, 2021.0195-6108http://hdl.handle.net/11449/21042810.3174/ajnr.A7057WOS:000644235100001Web of Sciencereponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengAmerican Journal Of Neuroradiologyinfo:eu-repo/semantics/openAccess2021-10-23T20:17:31Zoai:repositorio.unesp.br:11449/210428Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462021-10-23T20:17:31Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
A Diagnostic Algorithm for Posterior Fossa Tumors in Children: A Validation Study |
title |
A Diagnostic Algorithm for Posterior Fossa Tumors in Children: A Validation Study |
spellingShingle |
A Diagnostic Algorithm for Posterior Fossa Tumors in Children: A Validation Study Alves, C. A. P. F. |
title_short |
A Diagnostic Algorithm for Posterior Fossa Tumors in Children: A Validation Study |
title_full |
A Diagnostic Algorithm for Posterior Fossa Tumors in Children: A Validation Study |
title_fullStr |
A Diagnostic Algorithm for Posterior Fossa Tumors in Children: A Validation Study |
title_full_unstemmed |
A Diagnostic Algorithm for Posterior Fossa Tumors in Children: A Validation Study |
title_sort |
A Diagnostic Algorithm for Posterior Fossa Tumors in Children: A Validation Study |
author |
Alves, C. A. P. F. |
author_facet |
Alves, C. A. P. F. Lobel, U. Martin-Saavedra, J. S. Toescu, S. Tsunemi, M. H. [UNESP] Teixeira, S. R. Mankad, K. Hargrave, D. Jacques, T. S. Costa Leite, C. da Goncalves, F. G. Vossough, A. D'Arco, F. |
author_role |
author |
author2 |
Lobel, U. Martin-Saavedra, J. S. Toescu, S. Tsunemi, M. H. [UNESP] Teixeira, S. R. Mankad, K. Hargrave, D. Jacques, T. S. Costa Leite, C. da Goncalves, F. G. Vossough, A. D'Arco, F. |
author2_role |
author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Childrens Hosp Philadelphia UCL Universidade Estadual Paulista (Unesp) Universidade de São Paulo (USP) |
dc.contributor.author.fl_str_mv |
Alves, C. A. P. F. Lobel, U. Martin-Saavedra, J. S. Toescu, S. Tsunemi, M. H. [UNESP] Teixeira, S. R. Mankad, K. Hargrave, D. Jacques, T. S. Costa Leite, C. da Goncalves, F. G. Vossough, A. D'Arco, F. |
description |
BACKGROUND AND PURPOSE: Primary posterior fossa tumors comprise a large group of neoplasias with variable aggressiveness and short and long-term outcomes. This study aimed to validate the clinical usefulness of a radiologic decision flow chart based on previously published neuroradiologic knowledge for the diagnosis of posterior fossa tumors in children. MATERIALS AND METHODS: A retrospective study was conducted (from January 2013 to October 2019) at 2 pediatric referral centers, Children?s Hospital of Philadelphia, United States, and Great Ormond Street Hospital, United Kingdom. Inclusion criteria were younger than 18 years of age and histologically and molecularly confirmed posterior fossa tumors. Subjects with no available preoperative MR imaging and tumors located primarily in the brain stem were excluded. Imaging characteristics of the tumors were evaluated following a predesigned, step-by-step flow chart. Agreement between readers was tested with the Cohen ?, and each diagnosis was analyzed for accuracy. RESULTS: A total of 148 cases were included, with a median age of 3.4?years (interquartile range, 2.1?6.1 years), and a male/female ratio of 1.24. The predesigned flow chart facilitated identification of pilocytic astrocytoma, ependymoma, and medulloblastoma sonic hedgehog tumors with high sensitivity and specificity. On the basis of the results, the flow chart was adjusted so that it would also be able to better discriminate atypical teratoid/rhabdoid tumors and medulloblastoma groups 3 or 4 (sensitivity = 75%?79%; specificity = 92%?99%). Moreover, our adjusted flow chart was useful in ruling out ependymoma, pilocytic astrocytomas, and medulloblastoma sonic hedgehog tumors. CONCLUSIONS: The modified flow chart offers a structured tool to aid in the adjunct diagnosis of pediatric posterior fossa tumors. Our results also establish a useful starting point for prospective clinical studies and for the development of automated algorithms, which may provide precise and adequate diagnostic tools for these tumors in clinical practice. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-06-25T15:20:19Z 2021-06-25T15:20:19Z 2021-03-04 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.3174/ajnr.A7057 American Journal Of Neuroradiology. Denville: Amer Soc Neuroradiology, v. 42, n. 5, p. 961-968, 2021. 0195-6108 http://hdl.handle.net/11449/210428 10.3174/ajnr.A7057 WOS:000644235100001 |
url |
http://dx.doi.org/10.3174/ajnr.A7057 http://hdl.handle.net/11449/210428 |
identifier_str_mv |
American Journal Of Neuroradiology. Denville: Amer Soc Neuroradiology, v. 42, n. 5, p. 961-968, 2021. 0195-6108 10.3174/ajnr.A7057 WOS:000644235100001 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
American Journal Of Neuroradiology |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
961-968 |
dc.publisher.none.fl_str_mv |
Amer Soc Neuroradiology |
publisher.none.fl_str_mv |
Amer Soc Neuroradiology |
dc.source.none.fl_str_mv |
Web of Science reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
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UNESP |
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Repositório Institucional da UNESP |
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Repositório Institucional da UNESP |
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Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
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1799964992897810432 |