Germinoma of basal ganglia.

Basal ganglia germinomas (BGGs) are rare lesions. Because of the atypical features of early-stage clinical symptoms and imaging characteristics, BGGs are easily misdiagnosed with non-tumorous conditions. This article presented cases of 2 young male patients who came to the hospital due to right arm weakness. Brain Magnetic Resonance Imaging (MRI) images in the first case revealed a lobulated mixed component mass on the left basal ganglia. The solid part showed restricted diffusion on diffusion-weighted imaging, heterogeneous strong enhancement, and no signal of calcification or bleeding. The second case in the left putamen showed hypointensity on T2*, mild enhancement, and atrophy of the ipsilateral cerebral peduncle, increased choline, and decreased n-acetyl-aspartate (NAA) on spectroscopy. Follow-up MRI after 6 months showed a mass increase in size and hypointensity part on T2*. BGGs have been confirmed on biopsy in both cases. With isolated chemotherapy application, there is no sign of remission in the first patient. The second patient was treated with chemotherapy and radiotherapy, and MRI images after treatment showed a complete response.

Evaluation of Factors Influenced on the Effectiveness of Percutaneous Nephrolithotomy.

Background: Generally, there are many methods for the treatment of urinary stones, of which percutaneous nephrolithotomy (PCNL) is a minimally invasive and highly effective method, and now become the first-line management for urinary stones, especially in the cases of complex stones and staghorne calculi. Accurate assessment of stone location, stone morphology, degree of hydronephrosis as well as urinary system abnormalities is extremely important in the percutaneous nephrolithotomy strategy. Objective: The aim of this study was to evaluate the S.T.O.N.E score as well as other factors that influenced the effectiveness of PCNL. Methods: Descriptive study on 71 patients with kidney stones, who underwent multi-slice CT scan of the urinary system before PCNL and then PCNL at Hanoi Medical University Hospital from July 2022 to July 2023. All patients received the informed consent and agreed to participate in the study. The factors included the stone area, the track length (from the skin surface to the stone central), the degree of urinary tract dilatation, the number of involved calyces, the density of stone, the renal parenchyma thickness, the ureteral wall thickness and fat infiltration measured on MSCT non-contrast phase. These factors were used to predict the effectiveness of PCNL including the stone clearance rate (SCR) and the operation time. Results: The mean age of the patient group was 53.8±12.3. The male/female ratio was 1.54. There was a significant difference (p<0.05) between the following factors and the operation time: the stone area (<400, 400-799, 800-1599 and >1600 mm2), the degree of urinary tract dilatation (no or might and moderate or severe dilatation), the number of involved calyces (≤ 2, 3 and staghorne calculi), the renal parenchyma thickness (<18 mm and ≥18mm). In contrast, there were no significant differences between the following factors and the surgery time (p>0.05): the track length (<100 and ≥100 mm), and the stone density (<950 and ≥950 HU). Regarding the S.T.O.N.E score (included five factors: Size, Track length, Obstruction, Number of involved calyces, and Evaluation of stone density), there was a strong correlation between S.T.O.N.E score and the surgery time (p<0.001, r=0.94), and the SCR (p=0.001, r=-0.97). Conclusion: The evaluation of these factors played an important role in the prediction of the effectiveness of PCNL.

Imaging characteristics of posterior interosseous nerve syndrome.

Posterior interosseous nerve syndrome (PINs) is a rare nerve compression syndrome that affects the deep branch of the radial nerve in the supinator muscle region. In this article, we aimed to report a case of a 58-year-old male who had clinical symptoms, electromyographic, ultrasound, and MRI features suggestive of PINs due to compressing the arcade of Frohse. He subsequently underwent surgical correlation at our hospital, and the clinical symptoms were improved significantly.

Pulmonary artery penetration due to fish bone ingestion: A rare case report.

Accidental fish bone ingestion is a common manifestation at emergency departments. In most cases, ingested foreign bodies usually pass uneventfully through the gastrointestinal tract and complications only present in less than 5% of all patients. In this report, we present the first documented case of pulmonary artery injury due to a fish bone in a 63-year-old male patient hospitalized with hemoptysis after accidentally swallowing a fish bone 30 days ago. This patient subsequently had surgery and endoscopy to safely remove the foreign body and then recovered well on a follow-up examination. For cases of fish bone ingestion, contrast-enhanced chest computed tomography is one of the most essential tools to assess vascular problems and associated mediastinal infections-risk factors for life-threatening and long-term recurrent inflammation. Reconstructing planes along the foreign body axis and changing windows when analyzing CT scans is necessary to avoid missing lesions and dilemmas.

Endovascular intervention with high-flow priapism: A case report.

High-flow priapism is a rare condition in the form of priapism unrelated to sexual stimulation. The disease causes a decline in quality of life and has the risk of causing long-term erectile dysfunction if not treated promptly. We report a case of a 48-year-old male patient with prolonged high-flow erection after trauma who received endovascular intervention with n-butyl-2 cyanoacrylate biological glue. Results after 40 days of intervention and use of sildenafil 25 mg/day, the patient has an erection and has normal sexual activity. Cavernous arteriovenous fistula causing priapism with high flow is a rare condition. Computed tomography helps supplement information about feeding vessels as well as accompanying injuries for comprehensive assessment before treatment. Currently, there are many treatment methods, but transcatheter arterial embolization is modality of choice for achieve clinical efficacy and can safely and flexibly reduce the risk of secondary erectile dysfunction.

Laparoscopic treatment for median arcuate ligament syndrome in children: A case report.

In median arcuate ligament syndrome (MALS), the median arcuate ligament compresses the celiac trunk and surrounding nerves leading to chronic functional abdominal pain and vague gastrointestinal symptoms. MALS can be effectively treated by dividing the arcuate ligament through open surgery or laparoscopy. This is a rare vascular condition and mostly encountered in adult patients. We hereby report a case of a pediatric patient diagnosed with MALS and treated successfully by laparoscopic approach. An 11-year-old girl presented with severe abdominal cramps for 3 months, accompanied by nonbilious vomiting. Computed tomography (CT) angiography demonstrated clear images of celiac trunk compression suggesting MALS. Laparoscopic surgery to cut the ligament and decompress the celiac artery was performed. The patient was discharged on day 7 postoperative with no recurrence of symptoms after 12 months of follow-up. This report suggested the diagnostic value of CT scan, and the safety and the feasibility of laparoscopic surgical techniques to treat MALS in children.

Imaging features of shoulder tuberculosis with rice bodies formation: A case report.

Osteoarticular tuberculosis is less common than pulmonary tuberculosis and is often overlooked in the differential diagnosis of people with joint disease. In this article, we present a case of a 71-year-old female patient admitted to the hospital because of pain and limited movement of her right shoulder for a year. The patient had diabetes for 10 years, and no history of tuberculosis or previous history of tuberculosis exposure. Blood test results showed inflammatory condition and positive IGRA test. X-ray, ultrasound and magnetic resonance imaging images revealed osteolytic and sclerotic lesions of the humeral head, diffuse thickening of the synovial membrane, and loose bodies in the joint and bursa. The clinical diagnosis was tuberculous inflammatory osteoarthritis of the right shoulder. The patient underwent arthroscopy surgery to remove loose bodies and the inflamed portion of the synovium and send them to the pathology department. Histopathological examination of the loose bodies and synovial membrane revealed features suggestive of tuberculosis of the shoulder joint. Afterward, the patient was treated with antituberculosis drugs according to the guideline and rehabilitation exercises. After 3 months of treatment, the clinical symptoms were reduced, the pain rating was decreased and the range of motion was increased.

Apparent diffusion coefficient histogram in the differentiation of benign and malignant testicular tumors.

Purpose: This retrospective study assessed the value of histogram parameters of the apparent diffusion coefficient (ADC) map (HA) in differentiating between benign and malignant testicular tumors. We compared the diagnostic performance of two different volume-of-interest (VOI) placement methods: VOI 1, the entire tumor; VOI 2, the tumor excluding its cystic, calcified, hemorrhagic, and necrotic portions. Materials and methods: We retrospectively evaluated 45 patients with testicular tumors examined with scrotal contrast-enhanced magnetic resonance imaging. These patients underwent surgery with the pathological result of seven benign and 39 malignant tumors. We calculated the HA parameters, including mean, median, maximum, minimum, kurtosis, skewness, entropy, standard deviation (SD), mean of positive pixels, and uniformity of positive pixels by the two different VOI segmentation methods. We compared these parameters using the chi-square test, Mann-Whitney U test, and area under the receiver operating characteristic curve (AUC) to determine their optimal cut-off, sensitivity (Se), and specificity (Sp). Result: This study included 45 patients with 46 testicular lesions (seven benign and 39 malignant tumors), one of which had bilateral testicular seminoma. With the VOI 1 method, benign lesions had significantly lower maximum ADC (p = 0.002), ADC skewness (p = 0.017), and ADC variance (p = 0.000) than malignant lesions. In contrast, their minimum ADC was significantly higher ADC (p = 0.000). With the VOI 2 method, the benign lesions had significantly higher ADC SD (p = 0.048) and maximum ADC (p = 0.015) than malignant lesions. In contrast, their minimum ADC was significantly lower (p = 0.000). With the VOI 1 method, maximum ADC, ADC variance, and ADC skewness performed well in differentiating benign and malignant testicular lesions with cut-offs (Se, Sp, AUC) of 1846.000 (74.4%, 100%, 0.883), 39198.387 (79.5%, 85.7%, 0.868), and 0.893 (48.7%, 100%, 0.758). Conclusion: The HA parameters showed value in differentiating benign and malignant testicular neoplasms. The entire tumor VOI placement method was preferable to the VOI placement method excluding cystic, calcified, hemorrhagic, and necrotic portions in measuring HA parameters. Using this VOI segmentation, maximum ADC performed best in discriminating benign and malignant testicular lesions, followed by ADC variance and skewness.

Sporadic Creutzfeldt-Jakob disease: Brain MRI lesion features from 2 cases reports.

Sporadic Creutzfeldt-Jakob disease (sCJD) is an uncommon prion disease, also a fatal degenerative brain disorder. We aimed to illustrate 2 clinical cases, a 60-year-old female and a 57-year-old male, who came to the hospital due to rapidly progressive cognitive decline. A 1.5T brain MRI in both patients detected cortical and basal ganglia signal abnormalities with diffuse, asymmetrical features. The patient underwent electroencephalography and cerebrospinal fluid tests, which showed abnormal waves and a positive 14-3-3 protein test in the CSF samples of both patients. According to the 2018 US Centers for Disease Control and Prevention (CDC) diagnostic criteria, we finally diagnosed these patients with sCJD.

Lingual bracket transfer accuracy of double vacuum-formed indirect bonding tray using 3D-printed model: an in vivo study.

INTRODUCTION: This study aimed to assess the transfer accuracy of a digital indirect bonding method for lingual brackets using double vacuum-formed trays in vivo. METHODS: Twenty-five patients in need of lingual orthodontic treatment were consecutively recruited. Bracket placement was performed on ideal setups, followed by fabricating indirect bonding trays through vacuum-forming on 3-dimensional printed models. Transfer accuracy was measured at each bracket after superimpositions of postbonding scans and reference data. One-tailed t tests were used to determine whether bracket deviations were within the limit of 0.5 mm and 2° for linear and angular dimensions, respectively. RESULTS: A total of 611 lingual brackets were evaluated. Mean linear transfer errors were 0.06 mm, 0.09 mm, and 0.12 mm, with frequencies of deviations within the 0.5 mm limit of 99.7%, 99.8%, and 98.0% for mesiodistal, buccolingual, and occlusogingival dimensions, respectively. Regarding angular measurements, mean transfer errors were 1.28°, 1.73°, and 2.96°, with frequencies of deviations within the 2° limit of 81.0%, 68.9%, and 51.1% for rotation, tip, and torque, respectively. Mean errors fell within the clinically accepted limits for all linear dimensions and rotation but exceeded the limit for tip and torque. CONCLUSIONS: Lingual bracket indirect bonding using double vacuum-formed trays fabricated on 3-dimensional printed models has high transfer accuracy in the mesiodistal, buccolingual, and occlusogingival dimensions and rotation. However, the transfer of tip and torque is less accurate.

Radiofrequency catheter ablation for paroxysmal supraventricular tachycardia in children: Insights on its safety and efficacy from a lower middle-income country.

OBJECTIVE: Radiofrequency catheter ablation (RFCA) is a safe and effective treatment for paroxysmal supraventricular tachycardia in adults. However, data on its use in children, particularly from low- and middle-income countries, are limited. This study aimed to evaluate the safety and efficacy of RFCA in children with paroxysmal supraventricular tachycardia from Vietnam. METHODS: A prospective study was conducted from January 2009 to July 2016 at the University Medical Center, Ho Chi Minh City, Vietnam. Ninety-five children diagnosed with paroxysmal supraventricular tachycardia were enrolled; 90 patients underwent cardiac electrophysiology and RFCA. The patients were followed up for 3-12 months, with a mean follow-up period of 7.5 ± 2.3 months. RESULTS: The average age of the patients was 10.5 ± 3 years, with the youngest patient being 4 years old; 46.3% of the patients were female and 53.7% were male. The patients' average weight was 35.2 ± 9.6 kg. Atrioventricular reentrant tachycardia accounted for 72.6% of the cases and atrioventricular nodal reentrant tachycardia for 27.4% of the cases; no patients had atrial tachycardia. The success rate of RFCA was 98.9% (89/90 patients). During the 12-month follow-up, 5.6% of the patients experienced recurrence but were successfully treated with a second ablation. No severe complications were reported during the procedure and follow-up. CONCLUSIONS: This study found RFCA to be a safe and effective treatment for paroxysmal supraventricular tachycardia in children. It demonstrated a high success rate and low recurrence and complication rates for RFCA in children, thereby highlighting the potential advantages of the procedure as a treatment option.

Gallbladder perforation following trauma in an 18-month-old child with a common bile duct cyst.

Gallbladder rupture caused by blunt abdominal trauma is an uncommon injury, particularly in children. This condition occurs even less frequently in children with common bile duct cysts. The history is difficult to obtain, the clinical symptoms are indistinct, and their assessment is obscured by a slew of other lesions. Radiography cannot produce clear images. Thus, the diagnosis is frequently delayed and confirmed only during surgery. Case reports of gallbladder injury after abdominal trauma are relatively rare and there are only 50 case reports in literature for 100 years. Herein, we present the case of an 18-month-old girl who had a ruptured gallbladder funnel due to blunt abdominal trauma caused by domestic violence, with an early clinical presentation of septic shock and chylous effusion. The patient underwent surgery after being diagnosed with chylous ascites that had not responded to medical treatment. Based on the findings, single-stage laparoscopic surgery is confirmed to aid in the diagnosis and treatment of gallbladder injury in the presence of a common bile duct cyst.

Small-cell cancer of the perihilar bile duct with bleeding esophageal varices: A report of a rare case.

Small-cell cancer is an uncommon histological subtype of neuroendocrine carcinoma. It frequently has a poor prognosis because of distant metastasis. It is diagnosed using histopathological and immunohistochemical tests. We report the case of a 29-year-old female with small-cell cancer in the perihilar bile duct who presented with bleeding esophageal varices. This case report aims to improve physicians' understanding of small-cell cancer, thereby helping to reduce the frequency of missed clinical diagnoses.

Differentiation of glioblastoma and primary central nervous system lymphomas using multiparametric diffusion and perfusion magnetic resonance imaging.

The present study aimed to determine whether combining diffusion-weighted (DWI) and dynamic susceptibility contrast-enhanced perfusion-weighted (DSC-PWI) magnetic resonance imaging (MRI) could differentiate between primary central nervous system lymphoma (PCNSL) and glioblastoma (GBM). The present retrospective study evaluated 45 patients with histologically confirmed brain tumors, of which 18 had PCNSLs and 27 had GBMs. All patients underwent conventional, DWI, and DSC-PWI MRIs before the surgical removal of the lesion or stereotactic biopsy. The solid tumor component, peritumoral edema, and abnormal white matter were measured in three regions of interest to evaluate relative cerebral blood volume (rCBV), apparent diffusion coefficient (ADC) and DWI. In conventional MRI, there were significant differences in tumor numbers, tumor enhancement type, tumor necrosis, hemorrhage and open-ring sign between GBM and PCNSL. Solid tumor ADC and rCBV values (ADCt and rCBVt, respectively) and their ratios with abnormal white matter amounts were significantly higher in GBM cases than in PCNSL cases (P<0.05). The rCBV value for peritumoral edema (rCBVe) and its ratio with abnormal white matter amount (rCBVe/n) were significantly higher in GBM cases than in PCNSL cases (P<0.05). However, ADC values did not differ significantly for peritumoral edema. DWI values did not differ significantly. Combining rCBVt and rCBVe/n provided a perfect area under the receiver operating characteristic curve of 1.00, with 100% sensitivity and 100% specificity for distinguishing GBM from PCNSL. In the results of the present study, the major criterion in the decision-making process distinguishing PCNSL from GBM was the combined rCBVt and rCBVe/n parameter. A minor criterion was the ADCt value of the lesion.

Treatment outcomes of EGFR-TKI with or without locoregional brain therapy in advanced EGFR-mutant non-small cell lung cancer patients with brain metastases.

Introduction: This study aimed to evaluate the treatment outcomes of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy alone or in combination with locoregional brain therapy for advanced EGFR-mutant non-small cell lung cancer (NSCLC) patients with brain metastases. Material and methods: A retrospective study involving 72 advanced EGFR-mutant NSCLC patients with brain metastases at the Vietnam National Cancer Hospital were conducted. Patients were divided into 2 groups: EGFR-TKI (erlotinib) monotherapy and EGFR-TKI combined with locoregional therapy (γ knife surgery - GKS or whole-brain radiation therapy). Evaluation criteria included clinical and laboratory characteristics, central nervous system (CNS) progression time, progression-free survival (PFS), overall survival (OS), T790M mutation rate, and adverse events. Results: Epidermal growth factor receptor tyrosine kinase inhibitor monotherapy patients had better performance status (PS), fewer CNS symptoms, and significantly fewer brain metastases (p < 0.05). Median PFS and OS were 11 and 25 months, respectively, in both groups. Patients with PS 0-1 had longer median PFS (15 months) than those with PS 2 (7 months) (p = 0.039). Exon 19 deletion patients in both groups had longer median OS (26 months) than those with L858R exon 21 (15 months) (p = 0.023). Patients with T790M mutation who received osimertinib after progression had longer median OS (41 months vs. 23 months, p = 0.0001). Median time to CNS progression was 13.9 months (48 patients). Longer time to CNS progression correlated with longer OS (R2 = 0.89). Conclusions: Epidermal growth factor receptor tyrosine kinase inhibitor therapy, with or without locoregional therapy, is effective for advanced EGFR-mutant NSCLC patients with brain metastases. Exon 19 deletion patients had better prognosis.

Current Status of Biological Treatment in Ankylosing Spondylitis Patients and Some Related Factors.

Background: Axial spondyloarthritis (axSpA) is a potentially disabling inflammatory arthritis of the spine, usually presenting as chronic back pain typically before the age of 45 years. It is often associated with one or more articular features, including synovitis, enthesitis, and dactylitis. It may also be associated with several non-articular features; these include uveitis, psoriasis, and inflammatory bowel diseases1. Objective: The aim of this article is to describe the status of using biological drugs and some related factors in treating ankylosing spondylitis in Vietnam. Methods: A joint prospective and retrospective cross-sectional descriptive study was conducted on 161 ankylosing spondylitis patients treated with biological drugs at the Centre for Rheumatology between January 2018 and July 2021. Data were collected at the first dose and after 3, 6, 12, 24, and 36 months, including general characteristics, clinical and para-clinical features, drug use status, and related factors. Results: Of the 161 patients, 86.3% were male, with a mean age of 31.1 ± 11.6 years and a mean disease duration of 7.6 ± 6.6 years. Most patients were started on biologics at stage II (46.6%) or III (28.6%). Moreover, 68.9% had active disease based on the Bath Ankylosing Spondylitis Disease Activity Index. The most commonly prescribed first-line therapy was anti-tumor necrosis factor (69.6%), with infliximab the most frequently prescribed drug (44.7%). The rate of biological drug treatment decreased gradually from 100% at the start to 77% after one year and 39.1% after three years. Moreover, 74% of patients changed drugs due to non-response, and 50% discontinued treatment for economic reasons. Age was associated with treatment adherence, and drug change rates were higher in female patients and patients with active disease. Age was significantly associated with drug discontinuation (p < 0.05). Conclusion: Infliximab was the most commonly prescribed first-line drug. The rate of biological therapy gradually decreased after three years. Most patients changed drugs due to non-response, and many discontinued the drugs for economic reasons. Among the individual and clinical factors, age was associated with treatment adherence.

A rare case of duodenal adenocarcinoma.

Duodenal adenocarcinoma is very rare. Its clinical picture is nonspecific and the diagnosis is often accidental. The factors that affect survival are difficult to determine because the number of patients is not high. The common site of duodenal tumors and surgical removal are also debatable. The treatment guidelines published so far have mostly been evaluated in retrospective studies conducted over a 20-year period with relatively small sample sizes. The author presents a case of duodenal adenocarcinoma in a 62-year-old male patient with a clinical manifestation of melena. Duodeno-cephalo-pancreatectomy was the surgical option.

Splenic ectopic pregnancy: Rare location of ectopic pregnancy, how does it present?

Splenic ectopic pregnancy (SEP) is a rare high-mortality condition, particularly relating to life-threatening intraperitoneal bleeding due to a high risk of spontaneous rupture. Diagnosing in a timely fashion is extremely crucial and the patients could benefit from active treatment strategies and early management. In this article, we reviewed a case of 40 years-old female who complained of lower quadrant abdominal pain and amenorrhea with a history of intrauterine device (IUD) insertion for over 6 years. Elevating b-human chorionic gonadotropin (HCG) blood levels were documented, raising concern about pregnancy-related emergency conditions. Ultrasound and magnetic resonance imaging results suggested a splenic ectopic pregnancy entity with a high rupture rate. The patient subsequently underwent laparoscopic resection for splenic mass removal. Ectopic pregnancy should cautiously be excluded in all cases of abdominal pain in childbearing-age women.

The role of 3-Tesla magnetic resonance perfusion and spectroscopy in distinguishing glioblastoma from solitary brain metastasis.

Objectives: This study aimed to assess the value of magnetic resonance perfusion (MR perfusion) and magnetic resonance spectroscopy (MR spectroscopy) in 3.0-Tesla magnetic resonanceimaging (MRI) for differential diagnosis of glioblastoma (GBM) and solitary brain metastasis (SBM). Material and Methods: This retrospective study involved 36 patients, including 24 cases of GBM and 12 of SBM diagnosed using histopathology. All patients underwent a 3.0-Tesla MRI examination with pre-operative MR perfusion and MR spectroscopy. We assessed the differences in age, sex, cerebral blood volume (CBV), relative CBV (rCBV), and the metabolite ratios of choline/N-acetylaspartate (Cho/NAA) and Cho/creatine between the GBM and SBM groups using the Mann-Whitney U-test and Chi-square test. The cutoff value, area under the curve, sensitivity, specificity, positive predictive value, and negative predictive value of the significantly different parameters between these two groups were determined using the receiver operating characteristic curve. Results: In MR perfusion, the CBV of the peritumoral region (pCBV) had the highest preoperative predictive value in discriminating GBM from SBM (cutoff: 1.41; sensitivity: 70.83%; and specificity: 83.33%), followed by the ratio of CBV of the solid tumor component to CBV of normal white matter (rCBVt/n) and the ratio of CBV of the pCBV to CBV of normal white matter (rCBVp/n). In MR spectroscopy, the Cho/NAA ratio of the pCBV (pCho/NAA; cutoff: 1.02; sensitivity: 87.50%; and specificity: 75%) and the Cho/NAA ratio of the solid tumor component (tCho/NAA; cutoff: 2.11; sensitivity: 87.50%; and specificity: 66.67%) were significantly different between groups. Moreover, combining these remarkably different parameters increased their diagnostic utility for distinguishing between GBM and SBM. Conclusion: pCBV, rCBVt/n, rCBVp/n, pCho/NAA, and tCho/NAA are useful indices for differentiating between GBM and SBM. Combining these indices can improve diagnostic performance in distinguishing between these two tumors.

Deciphering Machine Learning Decisions to Distinguish between Posterior Fossa Tumor Types Using MRI Features: What Do the Data Tell Us?

Machine learning (ML) models have become capable of making critical decisions on our behalf. Nevertheless, due to complexity of these models, interpreting their decisions can be challenging, and humans cannot always control them. This paper provides explanations of decisions made by ML models in diagnosing four types of posterior fossa tumors: medulloblastoma, ependymoma, pilocytic astrocytoma, and brainstem glioma. The proposed methodology involves data analysis using kernel density estimations with Gaussian distributions to examine individual MRI features, conducting an analysis on the relationships between these features, and performing a comprehensive analysis of ML model behavior. This approach offers a simple yet informative and reliable means of identifying and validating distinguishable MRI features for the diagnosis of pediatric brain tumors. By presenting a comprehensive analysis of the responses of the four pediatric tumor types to each other and to ML models in a single source, this study aims to bridge the knowledge gap in the existing literature concerning the relationship between ML and medical outcomes. The results highlight that employing a simplistic approach in the absence of very large datasets leads to significantly more pronounced and explainable outcomes, as expected. Additionally, the study also demonstrates that the pre-analysis results consistently align with the outputs of the ML models and the clinical findings reported in the existing literature.