Differentiating high and low grade pediatric brain tumors using diffusional kurtosis imaging

2015 ◽  
Vol 02 (04) ◽  
pp. 301-305
Author(s):  
Jens Jensen ◽  
Vitria Adisetiyo ◽  
Els Fieremans ◽  
Joseph Helpern ◽  
Matthias Karajannis ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Pediatric Brain Tumors ◽  
Low Grade ◽  
Diffusional Kurtosis Imaging ◽  
Pediatric Brain

Delayed cognitive, behavioral, and radiological changes related to canial irradiation for pediatric brain tumors

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 20023-20023
Author(s):  
M. M. Abdel Wahab ◽  
H. Hussien ◽  
K. M. Maher
Keyword(s):  
White Matter ◽  
Brain Tumors ◽  
Visual Memory ◽  
Statistical Significance ◽  
Pediatric Brain Tumors ◽  
Low Grade ◽  
White Matter Damage ◽  
Cranial Radiation ◽  
Pediatric Brain

20023 Purpose: To evaluate the delayed adverse changes in neuro-cognitive functions as well as white matter damage in radiated survivors of pediatric brain tumors. Methods: Forty two children (22 males) with primary brain tumors who were only treated with cranial radiation, were recruited. 28 patients were treated for low risk medulloblastoma, 10 patients for low grade astrocytoma, 3 patients for low grade ependymoma, and 1 patient for craniopharyngioma. Their ages ranged from 3 to 18 years (mean 10.3±3.98 years).They were subjected, initially just before radiotherapy and at follow-up 1–2 year after completion of cranial radiation, to serial clinical and neuropsychological assessments including Wechseler Intelligence Scale for Children, Vineland social maturity test, Benton Visual Memory Test, and Revised Behavior Problem Checklist. Magnetic resonance scans were also performed to detect the presence of white matter damage before radiotherapy and at follow up. Results: Initially, after surgery and before radiation, intelligence test scores were below normal scores for age and this was of high statistical significance (Total IQ: t= -3.02, P= 0.006). Visual memory test showed evidence of organicity in all cases. Social maturity showed a statistically significant decline as well (t= -2.11, P= 0.04). Follow-up after radiotherapy showed further decline with high statistical significance (Total IQ t= 3.228, P=0.003; visual memory t= 4.08, P= 0.001); An attentional problem has emerged (t= -6.12, P= 0.00). Both radiation dose and volume of radiation showed negative and statistically significant correlation with IQ. Age at diagnosis correlated positively and significantly with IQ ( r= 0.601, P=0.001). Multiple linear regression showed impaired neurocognitive function which was correlated with the degree of white matter damage. (standardized B= -0.577, P= 0.001) and young age at diagnosis (standardized B= -0.427, P= 0.014). Conclusions: Cranial radiation in pediatric brain tumors is associated with a decline in multiple neurocognitive functions including total IQ, visual memory, and attention; which are related to the toxic effect of cranial radiation on white matter of the brain especially in young age of childhood with high dose and whole cranial radiation. No significant financial relationships to disclose.

scholarly journals Comparison of Diffusion and Perfusion Techniques in Differentiating High Versus Low Grade Pediatric Brain Tumors

2020 ◽  
Vol 3 ◽  
Author(s):  
Eric Chen ◽  
Chang Ho ◽  
Benjamin Gray ◽  
Jason Parker ◽  
Emily Diller ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Tumor Grade ◽  
Pediatric Brain Tumors ◽  
Solid Cancer ◽  
Low Grade ◽  
Dynamic Susceptibility ◽  
High Grade ◽  
Dynamic Contrast Enhancement ◽  
Significant Difference ◽  
Pediatric Brain

Background/Objective: Brain tumors are the most common solid cancer in children and cause significant mortality and morbidity. We compare the effectiveness of different parameters in predicting tumor grade between dynamic contrast enhancement (DCE), intravoxel incoherent motion (IVIM), dynamic susceptibility contrast (DSC) perfusion and diffusion weighted imaging (DWI).    Methods: A retrospective blinded review of pediatric brain tumors with DCE, IVIM, DWI, and DSC was performed. Parametric maps were registered to T2 weighted images. Volumetric regions of interest (ROI) were manually segmented from solid tumor components for each patient by a neuroradiologist (CH), neuroradiology fellow (BG), and medical student (EC). Resulting mean values for parameters from DCE (Ktrans, Kep, Ve, Vp,), IVIM (D, D*, f), DSC (rCBV) and DWI (ADC) were compared using Student’s t-test for high- and low-grade tumor groups based on WHO grading from pathology. For significant parameters, receiver operating characteristic (ROC) analysis with area under curve (AUC) was performed.     Results: 20 subjects were included with 9 low grade and 11 high grade tumors. Significant differences between low versus high grade were demonstrated for D (10−3 mm2/s) (1.4±0.4 vs 0.9±0.2, p=0.01), f (0.04±0.02 vs 0.07±0.02, p=0.02), ADC (10−3 mm2/s) (1.4±0.4 vs 0.9±0.3, p=0.009) and rCBV (2.2±0.9 vs 4.7±2.1, p=0.003). No significant difference was found for D* or any DCE parameter. AUC from ROC was similar for all significant parameters [D (0.81, p=0.003); f (0.80, p=0.003); ADC (0.83, p=0.001); rCBV (0.83, p=0.0005)].    Conclusion: D and f parameters from IVIM can significantly differentiate high versus low grade pediatric brain tumors similar to ADC and rCBV. Conversely, no DCE parameter was significant.    Scientific Implications: The results will assist the selection of MRI sequences that best predict tumor grade, as well as guide tumor biopsy for the most aggressive tumor portions. Further study of these techniques may correlate with molecular profiling and predict outcome. 

scholarly journals LG-07 * MOSAIC GENETIC PROGRESSION MODELS OF LOW GRADE PEDIATRIC BRAIN TUMORS REVEAL UNIQUE FEATURES OF TUMOR EVOLUTION

2015 ◽  
Vol 17 (suppl 3) ◽  
pp. iii19-iii19
Author(s):  
C. D. Antonuk ◽  
R. Levy ◽  
J. Molina ◽  
M. Danielpour ◽  
A. Akhtar ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Pediatric Brain Tumors ◽  
Tumor Evolution ◽  
Low Grade ◽  
Pediatric Brain

scholarly journals Detection of human herpesvirus-6 variants in pediatric brain tumors: Association of viral antigen in low grade gliomas

2009 ◽  
Vol 46 (1) ◽  
pp. 37-42 ◽  
Author(s):  
John R. Crawford ◽  
Maria R. Santi ◽  
Halldora K. Thorarinsdottir ◽  
Robert Cornelison ◽  
Elisabeth J. Rushing ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Viral Antigen ◽  
Human Herpesvirus ◽  
Pediatric Brain Tumors ◽  
Low Grade ◽  
Human Herpesvirus 6 ◽  
Low Grade Gliomas ◽  
Herpesvirus 6 ◽  
Pediatric Brain

scholarly journals Do Intratumoral And Peritumoral Apparent Diffusion Coefficient (ADC) Values Have A Role In The Diagnosis Of Pediatric Brain Tumors?

2020 ◽  
Author(s):  
Güleç Mert Doğan ◽  
Ahmet Sığırcı ◽  
Sevgi Taşolar ◽  
Aslınur Cengiz ◽  
Hilal Er Ulubaba ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Brain Tumors ◽  
Magnetic Resonance Image ◽  
Pediatric Patients ◽  
Pediatric Brain Tumors ◽  
Low Grade ◽  
High Grade ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Pediatric Brain

INTRODUCTION: The motion of water particles within biological tissues, which is called random Brownian motion, is detected at the microscopic level by Diffusion-Weighted Imaging (DWI) sequence of Magnetic Resonance Image technique. The Apparent Diffusion Coefficient (ADC) calculated on DWI has been used for tumor diagnosis and grading. The purpose of this study was to evaluate of ADC values in the differential diagnosis of supratentorial and infratentorial pediatric brain tumors and to reveal the difference of peritumoral ADC measurements of pediatric patients from adult patients. METHODS: All of the 56 pediatric patients included in this retrospective study had lesions >1 cm in diameter on magnetic resonance image and all of the diagnosies were confirmed by histopathology. Intratumoral and peritumoral ADC values and ratios were measured in diffusion weighted Magnetic Resonance Image. RESULTS: The 58.9% (n=33) of these tumors were supratentorial and 41.1% (n=23) were infratentorial. ADC values and ADC ratios were significantly lower in high-grade tumors than low-grade tumors (p<0.05). Peritumoral ADC values in high-grade tumors were lower than low grade tumors (p<0.05). The cut-off value of the ADC ratio between these two groups was 1 and the ADC cut-off value was 1.1*10-3 mm2/s. DISCUSSION AND CONCLUSION: In the differentiation of low and high-grade pediatric brain tumors, cut-off values of 1.1*10_3mm2/s for ADC Value and 1.0 for ADC Ratio may be useful. Although, peritumoral ADC values differ in children compared to the adult group, both intratumoral and peritumoral ADC values can help for grading pediatric brain tumors.

scholarly journals Advances in Targeted Therapies for Pediatric Brain Tumors

2020 ◽  
Vol 22 (12) ◽  
Author(s):  
Timothy Mueller ◽  
Ana Sofia Guerreiro Stucklin ◽  
Andreas Postlmayr ◽  
Sarah Metzger ◽  
Nicolas Gerber ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Targeted Therapies ◽  
Clinical Benefit ◽  
Pediatric Brain Tumors ◽  
Mapk Signaling ◽  
Mitogen Activated Protein Kinase ◽  
Molecular Heterogeneity ◽  
Low Grade ◽  
Combination Strategies ◽  
Pediatric Brain

Abstract Purpose of Review Over the last years, our understanding of the molecular biology of pediatric brain tumors has vastly improved. This has led to more narrowly defined subgroups of these tumors and has created new potential targets for molecularly driven therapies. This review presents an overview of the latest advances and challenges of implementing targeted therapies into the clinical management of pediatric brain tumors, with a focus on gliomas, craniopharyngiomas, and medulloblastomas. Recent Findings Pediatric low-grade gliomas (pLGG) show generally a low mutational burden with the mitogen-activated protein kinase (MAPK) signaling presenting a key driver for these tumors. Direct inhibition of this pathway through BRAF and/or MEK inhibitors has proven to be a clinically relevant strategy. More recently, MEK and IL-6 receptor inhibitors have started to be evaluated in the treatment for craniopharyngiomas. Aside these low-grade tumors, pediatric high-grade gliomas (pHGG) and medulloblastomas exhibit substantially greater molecular heterogeneity with various and sometimes unknown tumor driver alterations. The clinical benefit of different targeted therapy approaches to interfere with altered signaling pathways and restore epigenetic dysregulation is undergoing active clinical testing. For these multiple pathway-driven tumors, combination strategies will most likely be required to achieve clinical benefit. Summary The field of pediatric neuro-oncology made tremendous progress with regard to improved diagnosis setting the stage for precision medicine approaches over the last decades. The potential of targeted therapies has been clearly demonstrated for a subset of pediatric brain tumors. However, despite clear response rates, questions of sufficient blood-brain barrier penetration, optimal dosing, treatment duration as well as mechanisms of resistance and how these can be overcome with potential combination strategies need to be addressed in future investigations. Along this line, it is critical for future trials to define appropriate endpoints to assess therapy responses as well as short and long-term toxicities in the growing and developing child.

scholarly journals Magnetic resonance–guided stereotactic laser ablation therapy for the treatment of pediatric brain tumors: a multiinstitutional retrospective study

2020 ◽  
Vol 26 (1) ◽  
pp. 13-21
Author(s):  
Elsa V. Arocho-Quinones ◽  
Sean M. Lew ◽  
Michael H. Handler ◽  
Zulma Tovar-Spinoza ◽  
Matthew Smyth ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Brain Tumors ◽  
Adjuvant Treatment ◽  
Pediatric Brain Tumors ◽  
Tumor Location ◽  
Neurological Deficits ◽  
Low Grade ◽  
High Grade ◽  
Pediatric Brain

OBJECTIVEThis study aimed to assess the safety and efficacy of MR-guided stereotactic laser ablation (SLA) therapy in the treatment of pediatric brain tumors.METHODSData from 17 North American centers were retrospectively reviewed. Clinical, technical, and radiographic data for pediatric patients treated with SLA for a diagnosis of brain tumor from 2008 to 2016 were collected and analyzed.RESULTSA total of 86 patients (mean age 12.2 ± 4.5 years) with 76 low-grade (I or II) and 10 high-grade (III or IV) tumors were included. Tumor location included lobar (38.4%), deep (45.3%), and cerebellar (16.3%) compartments. The mean follow-up time was 24 months (median 18 months, range 3–72 months). At the last follow-up, the volume of SLA-treated tumors had decreased in 80.6% of patients with follow-up data. Patients with high-grade tumors were more likely to have an unchanged or larger tumor size after SLA treatment than those with low-grade tumors (OR 7.49, p = 0.0364). Subsequent surgery and adjuvant treatment were not required after SLA treatment in 90.4% and 86.7% of patients, respectively. Patients with high-grade tumors were more likely to receive subsequent surgery (OR 2.25, p = 0.4957) and adjuvant treatment (OR 3.77, p = 0.1711) after SLA therapy, without reaching significance. A total of 29 acute complications in 23 patients were reported and included malpositioned catheters (n = 3), intracranial hemorrhages (n = 2), transient neurological deficits (n = 11), permanent neurological deficits (n = 5), symptomatic perilesional edema (n = 2), hydrocephalus (n = 4), and death (n = 2). On long-term follow-up, 3 patients were reported to have worsened neuropsychological test results. Pre-SLA tumor volume, tumor location, number of laser trajectories, and number of lesions created did not result in a significantly increased risk of complications; however, the odds of complications increased by 14% (OR 1.14, p = 0.0159) with every 1-cm3 increase in the volume of the lesion created.CONCLUSIONSSLA is an effective, minimally invasive treatment option for pediatric brain tumors, although it is not without risks. Limiting the volume of the generated thermal lesion may help decrease the incidence of complications.

scholarly journals Neuropilin-1: A Key Protein to Consider in the Progression of Pediatric Brain Tumors

2021 ◽  
Vol 11 ◽  
Author(s):  
Manon Douyère ◽  
Pascal Chastagner ◽  
Cédric Boura
Keyword(s):  
Brain Tumors ◽  
Neuronal Development ◽  
Young Patients ◽  
Life Quality ◽  
Pediatric Brain Tumors ◽  
Low Grade ◽  
Neuropilin 1 ◽  
Relevant Role ◽  
Pediatric Brain

Neuropilins are transmembrane glycoproteins that play important roles in cardiovascular and neuronal development, as well as in immunological system regulations. NRP1 functions as a co-receptor, binding numerous ligands, such as SEMA 3 or VEGF and, by doing so, reinforcing their signaling pathways and can also interface with the cytoplasmic protein synectin. NRP1 is expressed in many cancers, such as brain cancers, and is associated with poor prognosis. The challenge today for patients with pediatric brain tumors is to improve their survival rate while minimizing the toxicity of current treatments. The aim of this review is to highlight the involvement of NRP1 in pediatric brain cancers, focusing essentially on the roles of NRP1 in cancer stem cells and in the regulation of the immune system. For this purpose, recent literature and tumor databases were analyzed to show correlations between NRP1 and CD15 (a stem cancer cells marker), and between NRP1 and PDL1, for various pediatric brain tumors, such as high- and low-grade gliomas, medulloblastomas, and ependymomas. Finally, this review suggests a relevant role for NRP1 in pediatric brain tumors progression and identifies it as a potential diagnostic or therapeutic target to improve survival and life quality of these young patients.

Sign in / Sign up

Export Citation Format

Share Document