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Research ArticleBrainF

Distinguishing between Germinomas and Pineal Cell Tumors on MR Imaging

N. Dumrongpisutikul, J. Intrapiromkul and D.M. Yousem
American Journal of Neuroradiology March 2012, 33 (3) 550-555; DOI: https://doi.org/10.3174/ajnr.A2806
N. Dumrongpisutikul
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J. Intrapiromkul
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D.M. Yousem
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    Fig 1.

    ADC map (A) with region of interest drawn (B), T2-weighted image (C) with region of interest drawn (D), and postcontrast T1-weighted image (E) with region of interest (F) are seen in this papillary tumor of the pineal gland. The standard deviations were divided by the means to obtain coefficients of variation.

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    Fig 2.

    Germinoma shows ADC value of 1500.68 × 10−6 mm2/s.

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    Fig 3.

    Pineoblastoma shows ADC value of 426.68 × 10−6 mm2/s.

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    Table 1:

    Age, T1, and T2 signal intensity values of the pineal region tumors

    TumorsAge Range (years)Mean Age (years) ± SD (years)T1 Value RangeMean T1 ± SDT2 Value RangeMean T2 ± SD
    Pineocytoma (n = 3)39.6–64.948.7 ± 14.1235.89–426.27305.58 ± 104.94616.11–995.52755.52 ± 208.75
    PPTID (n = 2)45.6–47.246.4 ± 1.1196.13–230.19213.16 ± 24.08321.74–593.47457.61 ± 192.14
    PTPR (n = 2)1.5–31.616.6 ± 21.3187.92–286.24237.08 ± 69.52437.58–804.67621.13 ± 259.57
    Pineoblastoma (n = 6)3.3–45.818.3 ± 15.0197.90–357.34282.44 ± 57.65232.2–478.97364.33 ± 98.34
    Germinoma (n = 7)9.3–20.613.7 ± 3.9191.00–433.79278.6 ± 90.43418.49–1297.99718.21 ± 294.14
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    Table 2:

    Characteristics of 20 pineal region masses

    DiagnosisSize-AP X transverse X SI (cm)Percent CysticHemorrhagic?Calcified? (modality used to assess)
    Pineoblastoma4.6 × 5.9 × 6.15.36NoNo, CT
    Pineoblastoma2.5 × 1.8 × 2.60.00NoNo, CT
    Pineoblastoma2.3 × 2.0 × 1.60.00NoYes, diffusely, CT
    Pineoblastoma1.7 × 1.9 × 1.80.00NoNo, CT
    Pineoblastoma2.5 × 2.1 × 2.640.38NoNo, CT
    Pineoblastoma3.3 × 2.6 × 4.70.00NoNo, CT
    Pineocytoma2.1 × 2.1 × 1.848.20NoNo, MR
    Pineocytoma1.9 × 1.8 × 1.30.00NoNo, CT
    Pineocytoma1.7 × 2.3 × 1.337.21NoNo, CT
    Intermediate pineal parenchymal tumor1.6 × 1.7 × 1.60.00NoNo, CT
    Intermediate pineal parenchymal tumor3.8 × 2.6 × 3.80.00NoNo, MR
    Papillary tumor of the pineal region2.1 × 2.0 × 2.926.53NoNo, CT
    Papillary tumor of the pineal region2.2 × 2.1 × 1.90.00NoNo, MR
    Germinoma3.1 × 3.7 × 3.60.00NoYes, punctate, CT
    Germinoma2.1 × 2.6 × 2.123.64NoNo, CT
    Germinoma2.9 × 3.1 × 1.940.29NoYes, punctate, CT
    Germinoma2.8 × 3.8 × 3.00.00NoNo, CT
    Germinoma2.1 × 2.3 × 2.50.00NoNo, CT
    Germinoma2.2 × 1.5 × 1.615.38NoNo, MR
    Germinoma0.8 × 0.8 × 0.70.00NoNo, MR
    • Note:—AP indicates anteroposterior; SI, signal intensity.

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    Table 3:

    Coefficient of variation (CV) of T1 and T2 signal intensity values and ADC values of the pineal region tumors

    Pineal Parenchymal Tumors (n = 13)Germinoma (n = 6)P
    Percentage of CV of T1 signal value ± SD11.14 ± 4.5711.71 ± 5.240.814
    Percentage of CV of T2 signal value ± SD26.71 ± 15.1723.19 ± 7.410.496
    Percentage of CV of ADC signal value ± SD28.79 ± 15.6323.64 ± 15.030.51
    • View popup
    Table 4:

    ADC values of the pineal region tumors

    TumorsRange ADC × 10−6 mm2/sMean ADC × 10−6 mm2/s ± SD × 10−6 mm2/s
    Pineocytoma (n = 3)1123.63–1229.561180.34 ± 53.36
    PPTID (n = 2)904.14–1067.35985.75 ± 115.41
    PTPR (n = 2)993.25–1296.421144.83 ± 214.37
    Pineoblastoma (n = 6)375.63–1027.49614.06 ± 239.65
    Germinoma (n = 6)*1168.49–2637.001590.69 ± 532.96
    • ↵* One germinoma was not able to be assessed.

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American Journal of Neuroradiology: 33 (3)
American Journal of Neuroradiology
Vol. 33, Issue 3
1 Mar 2012
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Cite this article
N. Dumrongpisutikul, J. Intrapiromkul, D.M. Yousem
Distinguishing between Germinomas and Pineal Cell Tumors on MR Imaging
American Journal of Neuroradiology Mar 2012, 33 (3) 550-555; DOI: 10.3174/ajnr.A2806

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Distinguishing between Germinomas and Pineal Cell Tumors on MR Imaging
N. Dumrongpisutikul, J. Intrapiromkul, D.M. Yousem
American Journal of Neuroradiology Mar 2012, 33 (3) 550-555; DOI: 10.3174/ajnr.A2806
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