Purpose or Case Report: The purpose of this exhibit is to ilustrate how the DTI color map can characterize the peritumoral zone in pediatric brain tumors, which is of potential benefit in preoperative planning.
Methods & Materials: Brain tumour cases at a pediatric teaching hospital were reviewed with repect to the DTI color map.Three categories of peritumoral zone were defined . One category was the dispalcement of white matter tracts by the tumor (the good) without destruction. The second was destruction of the white matter tracts (the bad) , while the third category was infiltration of the white matter tracts by tumor (the ugly). Each category was illustarted with numerous examples, covering with common and uncommon pediatric brain tumors.
Results: Tumors with displacement of the white matter tracts ( the good) included medulloblastoma, ependymoma, meningioma, and oligodendroglioma. Tumors with destroyed white matte tracts included anaplastic ependymoma, glioblastoma multiforme, and atypical teratoid rhabdoid tumour ( "the bad"). Tumors with infiltrated white matter tracts were optic nerve glioma, brainstem glioma, pilocytic astrocytoma, diffuse infiltrative pontine glioma ( " the ugly").
Conclusions: Color maps from DTI are useful in defining the relationship of tumor to adjacent white matter tracts and can help guide surgical planning.