A Diagnostic Algorithm for Posterior Fossa Tumors in Children: A Validation Study

• DOI: 10.3174/ajnr.a7057
• Publication Date: 2021-03-05T19:33:26Z
• Authors: C.A.P.F. Alves; U. Löbel; J.S. Martin-Saavedra; S. Toescu; M.H. Tsunemi; S.R. Teixeira; K. Mankad; D. Hargrave; T.S. Jacques; C. da Costa Leite; F.G. Gonçalves; A. Vossough; F. D'Arco
• Keywords: Ependymoma; Interquartile range; Pilocytic astrocytoma; Posterior fossa; Flow chart

<h3>BACKGROUND AND PURPOSE:</h3> Primary posterior fossa tumors comprise a large group of neoplasias with variable aggressiveness and short long-term outcomes. This study aimed to validate the clinical usefulness radiologic decision flow chart based on previously published neuroradiologic knowledge for diagnosis in children. <h3>MATERIALS METHODS:</h3> A retrospective was conducted (from January 2013 October 2019) at 2 pediatric referral centers, Children9s Hospital Philadelphia, United States, Great Ormond Street Hospital, Kingdom. Inclusion criteria were younger than 18 years age histologically molecularly confirmed tumors. Subjects no available preoperative MR imaging located primarily brain stem excluded. Imaging characteristics evaluated following predesigned, step-by-step chart. Agreement between readers tested Cohen κ, each analyzed accuracy. <h3>RESULTS:</h3> total 148 cases included, median 3.4 (interquartile range, 2.1–6.1 years), male/female ratio 1.24. The predesigned facilitated identification pilocytic astrocytoma, ependymoma, medulloblastoma <i>sonic hedgehog</i> high sensitivity specificity. On basis results, adjusted so that it would also be able better discriminate atypical teratoid/rhabdoid groups 3 or 4 (sensitivity = 75%–79%; specificity 92%–99%). Moreover, our useful ruling out astrocytomas, <h3>CONCLUSIONS:</h3> modified offers structured tool aid adjunct Our results establish starting point prospective studies development automated algorithms, which may provide precise adequate diagnostic tools these practice.