Diagnostic performance of axial T2-weighted MRI sequence for exclusion of brain tumour in paediatric patients with non-localizing symptoms

Gerrish, Amy C.; Malik, Luqman; Swain, Charlotte; Thomas, Adam G.; Jaspan, Timothy; Dineen, Rob A

Abstract

Objective
To establish diagnostic performance of a single axial T2-weighted sequence for detection of brain tumours in children with non-localizing symptoms, compared to a standard MRI protocol.

Methods
Retrospective analysis of children undergoing MRI brain imaging for suspected brain tumours with non-localizing symptoms over a 3-year period. Axial T2-weighted images were blindly reviewed by two experienced paediatric neuroradiologists. Primary analysis was calculation of diagnostic performance metrics for tumour identification using axial T2-weighted image only compared to the standard MRI protocol.

Results
For 312 children undergoing MRI brain during the study period, sensitivity and specificity for brain tumour detection based on axial T2-weighted images in children with non-localizing symptoms were 1.000 (95% confidence intervals 0.598, 1.000) and 0.998 (95% confidence interval 0.990, 0.999) respectively. Based on T2-weighted images alone, 50 patients (16%) were flagged as needing recall for further imaging compared to 14 (4.5%) recalled after the standard protocol.

Conclusions
Axial T2-weighted images have high sensitivity and specificity for detection of brain tumours in children with non-localizing symptoms but are associated with increased imaging recall rates. Prospective evaluation of this approach to identify patients requiring more comprehensive imaging is warranted.

Advances in knowledge
A truncated MRI protocol with single axial T2-weighted sequence has high diagnostic performance for brain tumour detection in children with non-localizing features. Radiologists can be reassured that a child with this presentation who is unable to complete the full MRI scan protocol is very unlikely to have a brain tumour missed provided an axial T2-weighted sequence is obtained.

Citation

Gerrish, A. C., Malik, L., Swain, C., Thomas, A. G., Jaspan, T., & Dineen, R. A. (in press). Diagnostic performance of axial T2-weighted MRI sequence for exclusion of brain tumour in paediatric patients with non-localizing symptoms. British Journal of Radiology,

• Journal Article Type: Article
• Acceptance Date: Nov 27, 2024
• Deposit Date: Nov 27, 2024
• Journal: British Journal of Radiology
• Print ISSN: 0007-1285
• Electronic ISSN: 1748-880X
• Publisher: British Institute of Radiology
• Peer Reviewed: Peer Reviewed
• Keywords: Magnetic resonance Imaging, paediatric, neuroradiology, brain tumour, neuro-oncology, diagnostic performance
• Public URL: https://nottingham-repository.worktribe.com/output/42477490
• Publisher URL: https://academic.oup.com/bjr