Pediatric Central Nervous System Tumors: State-of-the-Art and Debated Aspects

Foster, Mitchell; Harishchandra, Lalgudi Srinivasan; Mallucci, Conor

doi:10.3389/fped.2018.00309

Cited by 10 publications

(6 citation statements)

References 56 publications

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“…Similar requirements also apply to intraoperative MRI approaches. These MRI protocols usually require 3D‐isotropic, larger field‐of‐view images and visualization of fiducial markers (if applicable) or the patient's face and other anatomical landmarks for proper registration 56 …”

Section: Imaging Considerationsmentioning

confidence: 99%

Imaging of pediatric brain tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee/ASPNR White Paper

Jaju

Li²,

Dahmoush

et al. 2022

Pediatric Blood & Cancer

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Tumors of the central nervous system are the most common solid malignancies in children and the most common cause of pediatric cancer‐related mortality. Imaging plays a central role in diagnosis, staging, treatment planning, and response assessment of pediatric brain tumors. However, the substantial variability in brain tumor imaging protocols across institutions leads to variability in patient risk stratification and treatment decisions, and complicates comparisons of clinical trial results. This White Paper provides consensus‐based imaging recommendations for evaluating pediatric patients with primary brain tumors. The proposed brain magnetic resonance imaging protocol recommendations balance advancements in imaging techniques with the practicality of deployment across most imaging centers.

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Section: Imaging Considerationsmentioning

confidence: 99%

Imaging of pediatric brain tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee/ASPNR White Paper

Jaju

Li²,

Dahmoush

et al. 2022

Pediatric Blood & Cancer

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“…The principal drawback of 5-ALA-guided surgery is the lack of a strong predictor of usefulness in pediatric brain neoplasms: indeed, a strong uorescence enhancement correlates neither with preoperative MRI c.e. nor with tumor aggressivity [9].…”

Section: Discussionmentioning

confidence: 98%

“…In our surgical series, uorescein-guided technique is feasible and represents a useful adjunct in most of the pediatric intra-axial supratentorial tumors presenting with some degree of contrast enhancement at preoperative neuroimaging scans. Despite the heterogeneity of pediatric CNS tumors histotypes [1,9], these neoplasms usually present with variable patterns of c.e. on their preoperative MRI [8]; the c.e.…”

Section: Discussionmentioning

confidence: 99%

“…The mainstay of treatment is surgical resection [5,9]: it plays a fundamental part as a cytoreductive surgery with the valuable role of providing enough biological material for histopathological and genetic analysis. Radical resection can be considered curative in mostly pediatric-type low-grade gliomas and in circumscribed astrocytic gliomas; by the way, surgical approach must be associated with adjuvant chemotherapy and radiotherapy in case of embryonal tumors or in pediatric-type high-grade gliomas, often with a poor prognosis.…”

Section: Introductionmentioning

confidence: 99%

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The role of sodium fluorescein in pediatric supratentorial intra-axial tumor resection: new insights from a monocentric series of 33 consecutive patients

et al. 2022

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Surgical resection represents the mainstay of treatment, in pediatric central nervous system (CNS) tumors, and aggressive resection correlates with prognosis for several histotypes. Sodium uorescein (SF), a green, water-soluble dye, is used as neurosurgical uorescent tracer thanks to its property to accumulate in cerebral regions of blood-brain barrier disruption, acting as a valid tool to improve the extent of resection in tumors enhancing at preoperative MRI. Brain neoplasms represent a heterogeneous group of tumors in the pediatric age, constituting the most common solid cancers; they typically show a varying degree of contrast enhancement on MRI. In March 2016 the authors started a prospective, observational trial to evaluate intraoperative uorescence's characteristics of CNS tumors, the percentage of extent of resection thanks to uorescein aid and side effects related to uorescein administration. This report is based on a retrospective analysis of a group of 33 consecutive pediatric patients harboring a supratentorial lesion. In 17 of 33 (51.5%) procedures uorescence was reported as intense, in 14 of 33 (42.4%) moderate and in 2 of 33 (6.1%) slight. Intraoperative uorescence corresponds to preoperative MRI documented contrast enhancement. In 28 of 33 (84.8%) surgical procedures SF was considered useful, in 2 of 33 (6.1%) partial useful, and in 3 of 33 (9.1%) not essential because the tumor was already recognizable. No adverse effect to SF administration was registered. Fluorescein-guided surgery with a dedicated lter on the microscope is a safe and effective technique to improve visualization and resection of different pediatric brain tumors.

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“…As important consequences of these observations, careful preoperative planning, intraoperative neuronavigation, and neurophysiological monitoring are crucial also in pediatric neurosurgery, especially in case of high-grade and low-grade tumors located within eloquent regions ( de Oliveira et al, 2015 ; Coppola et al, 2016 ; Celtikci et al, 2017 ; Foley and Boop, 2017 ; Foster et al, 2018 ; Abdel Razek et al, 2020 ).…”

Section: Neurosurgical Implicationsmentioning

confidence: 99%

Structural networking of the developing brain: from maturation to neurosurgical implications

De Benedictis,

Rossi-Espagnet,

de Palma

et al. 2023

Front. Neuroanat.

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Modern neuroscience agrees that neurological processing emerges from the multimodal interaction among multiple cortical and subcortical neuronal hubs, connected at short and long distance by white matter, to form a largely integrated and dynamic network, called the brain “connectome.” The final architecture of these circuits results from a complex, continuous, and highly protracted development process of several axonal pathways that constitute the anatomical substrate of neuronal interactions. Awareness of the network organization of the central nervous system is crucial not only to understand the basis of children’s neurological development, but also it may be of special interest to improve the quality of neurosurgical treatments of many pediatric diseases. Although there are a flourishing number of neuroimaging studies of the connectome, a comprehensive vision linking this research to neurosurgical practice is still lacking in the current pediatric literature. The goal of this review is to contribute to bridging this gap. In the first part, we summarize the main current knowledge concerning brain network maturation and its involvement in different aspects of normal neurocognitive development as well as in the pathophysiology of specific diseases. The final section is devoted to identifying possible implications of this knowledge in the neurosurgical field, especially in epilepsy and tumor surgery, and to discuss promising perspectives for future investigations.

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Pediatric Central Nervous System Tumors: State-of-the-Art and Debated Aspects

Cited by 10 publications

References 56 publications

Imaging of pediatric brain tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee/ASPNR White Paper

Imaging of pediatric brain tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee/ASPNR White Paper

The role of sodium fluorescein in pediatric supratentorial intra-axial tumor resection: new insights from a monocentric series of 33 consecutive patients

Structural networking of the developing brain: from maturation to neurosurgical implications

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