Differentiating Low- and High-Grade Pediatric Brain Tumor Using Integrated DWI

Motivation: Pediatric brain tumors is the most common cancer among the pediatric population, and DWI-imaging offers a non-invasive method to assess tumor grade to guide appropriate treatments. Goal(s): The study investigates the feasibility of DISMANTLE, an integrated DWI approach for simultaneous assessment of tissue cellularity, vascularity, and heterogeneity, in differentiating high-grade and low-grade pediatric brain tumors. Approach: Seventy pediatric patients with brain tumors, categorized into high-grade and low-grade, were scanned with DWI sequence. Images were analyzed using DISMANTLE and 3 comparison models. Results: Removing the perfusion-related signal in DISMANTLE improved the accuracy and sensitivity of diffusion-related parameters in assessing pediatric brain tumor grades. Impact: The study emphasizes the importance of appropriate signal characterization and fitting strategies for high b-value DWI in robust assessment of brain tumors. Future DWI modeling should consider segmentally fitting the diffusion and perfusion-related signals.