This study confirmed changes seen in a cohort of 146 patients and 92 normal healthy age-similar controls in an independent cohort of 141 patients. Fractional anisotropy (FA) was analyzed using the TBSS tools in FSL. After surgery but before any additional therapy, FA was significantly reduced in both cohorts. Additionally, a large increase in the percentage of skeleton voxels where the patients at least reach the level of controls two years from diagnosis was observed. This suggest the possibility that the newer therapy is having a less toxic impact on the microstructural integrity in this pediatric medulloblastoma population.