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MRI of Pediatric Orbital Masses: Role of Quantitative Diffusion-weighted Imaging in Differentiating Benign from Malignant Lesions

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Abstract

Purpose

To systematically evaluate the utility of different magnetic resonance imaging (MRI) features, including quantitative diffusion-weighted imaging, in differentiating benign from malignant pediatric orbital masses.

Methods

The use of MRI in 40 pediatric patients with orbital masses was retrospectively reviewed. Multiple subjective and objective MRI parameters, including lesion mean apparent diffusion coefficient (ADC) values and lesion-to-thalamus ADC ratio were recorded. Bivariate analysis was done to identify parameters that were significantly different between benign and malignant subgroups. Receiver operating curves were used to establish optimal cut-off values for lesion mean ADC and lesion-to-thalamus ADC ratio for predicting benign versus malignant lesions.

Results

Lesion mean ADC, lesion-to-thalamus ADC ratio and extent of contrast enhancement showed statistically significant differences between the two subgroups. For distinguishing benign from malignant lesions, a lesion mean ADC cut-off value of 1.14 × 10−3 mm2/s provided a sensitivity of 84% and specificity of 100%, while an ADC ratio of 1.4 provided a sensitivity of 81% and specificity of 89%.

Conclusion

Quantitative diffusion-weighted imaging can be a useful adjunct in characterizing pediatric orbital masses by MRI, and thus help in clinical decision making.

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Authors and Affiliations

  1. Department of Medical Imaging, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave, 60611, Chicago, IL, USA

    Alok Jaju & Maura E. Ryan

  2. Stanley Manne Children’s Research Institute, Ann and Robert H. Lurie Children’s Hospital of Chicago, Department of Pediatrics, Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave, 60611, Chicago, IL, USA

    Karen Rychlik

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  1. Alok Jaju
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Correspondence to Alok Jaju.

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Conflict of interest

A. Jaju, K. Rychlik and M.E. Ryan declare that they have no competing interests.

Ethical standards

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this retrospective study, the informed consent requirement was waived by the Institutional Review Board. For images or other information within the manuscript which identify patients, consent was obtained from them and/or their legal guardians.

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Jaju, A., Rychlik, K. & Ryan, M.E. MRI of Pediatric Orbital Masses: Role of Quantitative Diffusion-weighted Imaging in Differentiating Benign from Malignant Lesions. Clin Neuroradiol 30, 615–624 (2020). https://doi.org/10.1007/s00062-019-00790-4

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  • DOI: https://doi.org/10.1007/s00062-019-00790-4

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