Mark S Shiroishi1, Ashok Panigrahy1,2, Kevin R Moore3, Marvin D Nelson1, Floyd H Gilles4, Ignacio Gonzalez-Gomez5, Stefan Blüml6,7. 1. Department of Radiology, Children's Hospital Los Angeles/Keck School of Medicine of USC, MS 81, 4650 Sunset Boulevard, Los Angeles, CA, 90027, USA. 2. Department of Pediatric Radiology, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA, USA. 3. Department of Radiology, Primary Children's Medical Center, Salt Lake City, UT, USA. 4. Department of Pathology, Children's Hospital Los Angeles/Keck School of Medicine of USC, Los Angeles, CA, USA. 5. Department of Pathology, All Children's Hospital, St. Petersburg, FL, USA. 6. Department of Radiology, Children's Hospital Los Angeles/Keck School of Medicine of USC, MS 81, 4650 Sunset Boulevard, Los Angeles, CA, 90027, USA. sbluml@chla.usc.edu. 7. Rudi Schulte Research Institute, Santa Barbara, CA, USA. sbluml@chla.usc.edu.
Abstract
INTRODUCTION: The specific goal of this study was to determine whether the inclusion of MRS had a measureable and positive impact on the accuracy of pre-surgical MR examinations of untreated pediatric brain tumors over that of MRI alone in clinical practice. METHODS: Final imaging reports of 120 pediatric patients with newly detected brain tumors who underwent combined MRI/MRS examinations were retrospectively reviewed. Final pathology was available in all cases. Group A comprised 60 subjects studied between June 2001 and January 2005, when MRS was considered exploratory and radiologists utilized only conventional MRI to arrive at a diagnosis. For group B, comprising 60 subjects studied between January 2005 and March 2008, the radiologists utilized information from both MRI and MRS. Furthermore, radiologists revisited group A (blind review, time lapse >4 years) to determine whether the additional information from MRS would have altered their interpretation. RESULTS: Sixty-three percent of patients in group A were diagnosed correctly, whereas in 10% the report was partially correct with the final tumor type mentioned (but not mentioned as most likely tumor), while in 27% of cases the reports were wrong. For group B, the diagnoses were correct in 87%, partially correct in 5%, and incorrect in 8% of the cases, which is a significant improvement (p < 0.005). Re-review of combined MRI and MRS of group A resulted 87% correct, 7% partially correct, and 7% incorrect diagnoses, which is a significant improvement over the original diagnoses (p < 0.05). CONCLUSION: Adding MRS to conventional MRI significantly improved diagnostic accuracy in preoperative pediatric patients with untreated brain tumors.
INTRODUCTION: The specific goal of this study was to determine whether the inclusion of MRS had a measureable and positive impact on the accuracy of pre-surgical MR examinations of untreated pediatric brain tumors over that of MRI alone in clinical practice. METHODS: Final imaging reports of 120 pediatric patients with newly detected brain tumors who underwent combined MRI/MRS examinations were retrospectively reviewed. Final pathology was available in all cases. Group A comprised 60 subjects studied between June 2001 and January 2005, when MRS was considered exploratory and radiologists utilized only conventional MRI to arrive at a diagnosis. For group B, comprising 60 subjects studied between January 2005 and March 2008, the radiologists utilized information from both MRI and MRS. Furthermore, radiologists revisited group A (blind review, time lapse >4 years) to determine whether the additional information from MRS would have altered their interpretation. RESULTS: Sixty-three percent of patients in group A were diagnosed correctly, whereas in 10% the report was partially correct with the final tumor type mentioned (but not mentioned as most likely tumor), while in 27% of cases the reports were wrong. For group B, the diagnoses were correct in 87%, partially correct in 5%, and incorrect in 8% of the cases, which is a significant improvement (p < 0.005). Re-review of combined MRI and MRS of group A resulted 87% correct, 7% partially correct, and 7% incorrect diagnoses, which is a significant improvement over the original diagnoses (p < 0.05). CONCLUSION: Adding MRS to conventional MRI significantly improved diagnostic accuracy in preoperative pediatric patients with untreated brain tumors.
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Authors: M Murphy; A Loosemore; A G Clifton; F A Howe; A R Tate; S A Cudlip; P R Wilkins; J R Griffiths; B A Bell Journal: Br J Neurosurg Date: 2002-08 Impact factor: 1.596
Authors: A Panigrahy; M D Krieger; I Gonzalez-Gomez; X Liu; J G McComb; J L Finlay; M D Nelson; F H Gilles; S Blüml Journal: AJNR Am J Neuroradiol Date: 2006-03 Impact factor: 3.825
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Authors: Karen A Manias; Lisa M Harris; Nigel P Davies; Kal Natarajan; Lesley MacPherson; Katharine Foster; Marie-Anne Brundler; Darren R Hargrave; Geoffery S Payne; Martin O Leach; Paul S Morgan; Dorothee Auer; Tim Jaspan; Theodoros N Arvanitis; Richard G Grundy; Andrew C Peet Journal: Pediatr Radiol Date: 2018-07-30
Authors: Karen A Manias; Simrandip K Gill; Lesley MacPherson; Adam Oates; Benjamin Pinkey; Paul Davies; Niloufar Zarinabad; Nigel P Davies; Ben Babourina-Brooks; Martin Wilson; Andrew C Peet Journal: Neurooncol Pract Date: 2019-05-09
Authors: Karen Manias; Simrandip K Gill; Niloufar Zarinabad; Paul Davies; Martin English; Daniel Ford; Lesley MacPherson; Ina Nicklaus-Wollenteit; Adam Oates; Guirish Solanki; Jenny Adamski; Martin Wilson; Andrew C Peet Journal: Neurooncol Pract Date: 2017-05-13