Reliability of Imaging-Based Diagnosis of Lateral Ventricular Masses in Children.

Abstract:

OBJECTIVE:We studied the accuracy of the radiologic diagnosis of lateral ventricular masses in children (<20 years of age). METHODS:In this retrospective study, data were collected from children with lateral ventricular masses managed in our unit between 2001 and 2016. There were 43 patients (26 boys and 17 girls; mean age, 12.1 years; range, 8 months to 20 years). Magnetic resonance imaging was available for 36 patients, whereas in 7 patients only a contrast-enhanced computed tomography scan was available. The images were read independently by 3 radiologists, who were blinded to the pathology. Two differential diagnoses were offered for each patient. The agreement between the 3 radiologists was calculated using the Fleiss κ statistic. RESULTS:The common pathologic diagnoses were subependymal giant cell astrocytoma (SEGA) (20.9%), low-grade astrocytoma (16.3%), high-grade astrocytoma (9.3%), choroid plexus papilloma (9.3%), and meningioma (9.3%). The sensitivity, specificity, and accuracy of the radiologic diagnoses were 62%, 96.7%, and 94.2%, respectively. Low-grade tumors such as low-grade gliomas, SEGAs, choroid plexus papillomas, and meningiomas were diagnosed with a high level of accuracy. High-grade gliomas, choroid plexus carcinomas, and other malignant neoplasms were difficult to diagnose on imaging. Cavernous angiomas were also difficult to diagnose. There was only fair agreement between the 3 radiologists (Fleiss κ = 0.24). CONCLUSIONS:The pathologic spectrum of lateral ventricular tumors in children is wide, and identifying the pathology on imaging is difficult for malignant tumors. Benign tumors such as SEGAs, low-grade astrocytomas, and choroid plexus papillomas are relatively easier to diagnose. There is significant interobserver variability in the radiologic diagnosis of these tumors.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Pandey SK,Mani SE,Sudhakar SV,Panwar J,Joseph BV,Rajshekhar V

doi

10.1016/j.wneu.2018.12.196

subject

Has Abstract

pub_date

2019-01-17 00:00:00

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(19)30072-5

pub_type

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