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Imaging Characteristics of Atypical Teratoid–Rhabdoid Tumor in Children Compared with Medulloblastoma

Korgun Koral1, Lynn Gargan2, Daniel C. Bowers3, Barjor Gimi1, Charles F. Timmons4, Bradley Weprin5 and Nancy K. Rollins1

1 Department of Radiology, University of Texas Southwestern Medical Center at Dallas and Children's Medical Center of Dallas, 1935 Motor St., Dallas, TX 75235.
2 Department of Neuro-oncology, Children's Medical Center of Dallas, Dallas, TX.
3 Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas and Children's Medical Center of Dallas, Dallas, TX.
4 Department of Pathology, University of Texas Southwestern Medical Center at Dallas and Children's Medical Center of Dallas, Dallas, TX.
5 Department of Neurosurgery, Children's Medical Center of Dallas, Dallas, TX.


Figure 1
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  		Fig. 1 —Kaplan-Meier plots show survival statistics of atypical teratoid–rhabdoid tumor and medulloblastoma. Dashed gray line indicates atypical teratoid–rhabdoid tumor, dashed black line indicates medulloblastoma, gray plus sign (+) indicates atypical teratoid–rhabdoid tumor censored data, black plus sign (+) indicates medulloblastoma censored data.

 

Figure 2
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  		Fig. 2A —9-year-old boy with medulloblastoma. Sagittal T2-weighted (TR/TE, 3,500/105) image shows solid, relatively homogeneous midline mass arising from fourth ventricle.

 

Figure 3
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  		Fig. 2B —9-year-old boy with medulloblastoma. On diffusion-weighted image, lesion shows restricted diffusion with apparent diffusion coefficient value of 0.43 x 10–3 mm2/s.

 

Figure 4
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  		Fig. 3A —16-month-old boy with atypical teratoid–rhabdoid tumor. Axial T2-weighted (TR/TE, 3,500/105) image shows large, heterogeneous mass in left cerebellopontine angle extending into left internal auditory canal.

 

Figure 5
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  		Fig. 3B —16-month-old boy with atypical teratoid–rhabdoid tumor. Diffusion-weighted image shows restricted diffusion in anterior solid component. Apparent diffusion coefficient value of solid tumor is 0.60 x 10–3 mm2/s.

 

Figure 6
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  		Fig. 4A —7-year-old girl with medulloblastoma. Although tumor heterogeneity in medulloblastoma is less common than in atypical teratoid–rhabdoid tumor, medulloblastoma can show heterogeneous signal. Axial T2-weighted (TR/TE, 3,500/105) image shows heterogeneous, mixed tumor arising from fourth ventricle.

 

Figure 7
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  		Fig. 4B —7-year-old girl with medulloblastoma. Although tumor heterogeneity in medulloblastoma is less common than in atypical teratoid–rhabdoid tumor, medulloblastoma can show heterogeneous signal. Diffusion-weighted image of solid component of tumor shows restricted diffusion. Apparent diffusion coefficient calculated from solid component of tumor is 0.31 x 10–3 mm2/s.

 

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