Role of diffusion weighted imaging for differentiating cerebral pilocytic astrocytoma and ganglioglioma BRAF V600E-mutant from wild type

Ramaglia, Antonia; Tortora, Domenico; Mankad, Kshitij; Lequin, Maarten; Severino, Mariasavina; D’Arco, Felice; Löbel, Ulrike; Benenati, Massimo; Leng, Wendy W.J. de; Marco, Patrizia De; Milanaccio, Claudia; Rossi, Andrea; Morana, Giovanni

doi:10.1007/s00234-019-02304-y

Cited by 17 publications

(17 citation statements)

References 40 publications

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“…The aggressive biology of H3F3A-mutated gliomas that is typically associated with increased cellularity and lower diffusibility has been linked to lower ADC values in children with diffuse intrinsic pontine gliomas [ 66 ]. Additionally, children with BRAF V600E-mutant pilocytic astrocytoma were noted to have remarkably lower ADC means than the wild type and relatively unfavorable clinical outcomes [ 67 ].…”

Section: Mri Techniquesmentioning

confidence: 99%

Advanced Neuroimaging Approaches to Pediatric Brain Tumors

Nikam¹,

Yue²,

Kaur³

et al. 2022

Cancers

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Central nervous system tumors are the most common pediatric solid tumors; they are also the most lethal. Unlike adults, childhood brain tumors are mostly primary in origin and differ in type, location and molecular signature. Tumor characteristics (incidence, location, and type) vary with age. Children present with a variety of symptoms, making early accurate diagnosis challenging. Neuroimaging is key in the initial diagnosis and monitoring of pediatric brain tumors. Conventional anatomic imaging approaches (computed tomography (CT) and magnetic resonance imaging (MRI)) are useful for tumor detection but have limited utility differentiating tumor types and grades. Advanced MRI techniques (diffusion-weighed imaging, diffusion tensor imaging, functional MRI, arterial spin labeling perfusion imaging, MR spectroscopy, and MR elastography) provide additional and improved structural and functional information. Combined with positron emission tomography (PET) and single-photon emission CT (SPECT), advanced techniques provide functional information on tumor metabolism and physiology through the use of radiotracer probes. Radiomics and radiogenomics offer promising insight into the prediction of tumor subtype, post-treatment response to treatment, and prognostication. In this paper, a brief review of pediatric brain cancers, by type, is provided with a comprehensive description of advanced imaging techniques including clinical applications that are currently utilized for the assessment and evaluation of pediatric brain tumors.

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Section: Mri Techniquesmentioning

confidence: 99%

Advanced Neuroimaging Approaches to Pediatric Brain Tumors

Nikam¹,

Yue²,

Kaur³

et al. 2022

Cancers

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“…ADC maps were calculated using clinically integrated postprocessing software (Olea Sphere v2.3, Olea Medical). Two board certified neuroradiologists with subspecialisation in neuro-oncology (ST 5-year experience and CM 10-year experience) in consensus placed ADC regions of interest (ROIs) according to published methods (26)(27)(28); three small (30-40 mm 2 ) ROIs were sited in the visually perceived lowest ADC portions of each H3 K27M-mutant glioma on one or more image slices. The mean value of the lowest ADC measurement was designated the minimum ADC value (ADC min ) (28).…”

Section: Adc Quantificationmentioning

confidence: 99%

Imaging characteristics of H3 K27M histone-mutant diffuse midline glioma in teenagers and adults

Thust¹,

Micallef²,

Okuchi³

et al. 2021

Quant Imaging Med Surg

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Background: To assess anatomical and quantitative diffusion-weighted MR imaging features in a recently classified lethal neoplasm, H3 K27M histone-mutant diffuse midline glioma [World Health Organization (WHO) IV].Methods: Fifteen untreated gliomas in teenagers and adults (median age 19, range, 14-64) with confirmed H3 K27M histone-mutant genotype were analysed at a national referral centre. Morphological characteristics including tumour epicentre(s), T2/FLAIR and Gadolinium enhancement patterns, calcification, haemorrhage and cyst formation were recorded. Multiple apparent diffusion coefficient (ADC min , ADC mean ) regions of interest were sited in solid tumour and normal appearing white matter (ADC NAWM ) using post-processing software (Olea Sphere v2.3, Olea Medical). ADC histogram data (2 nd , 5 th , 10 th percentile, median, mean, kurtosis, skewness) were calculated from volumetric tumour segmentations and tested against the regions of interest (ROI) data (Wilcoxon signed rank test). Results:The median interval from imaging to tissue diagnosis was 9 (range, 0-74) days. The structural MR imaging findings varied between individuals and within tumours, often featuring signal heterogeneity on all MR sequences. All gliomas demonstrated contact with the brain midline, and 67% exhibited rimenhancing necrosis. The mean ROI ADC min value was 0.84 (±0.15 standard deviation, SD) ×10 −3 mm 2 /s. In the largest tumour cross-section (excluding necrosis), an average ADC mean value of 1.12 (±0.25)×10 −3 mm 2 /s was observed. The mean ADC min/NAWM ratio was 1.097 (±0.149), and the mean ADC mean/NAWM ratio measured 1.466 (±0.299). With the exception of the 2 nd centile, no statistical difference was observed between the regional and histogram derived ADC results.Conclusions: H3 K27M-mutant gliomas demonstrate variable morphology and diffusivity, commonly featuring moderately low ADC values in solid tumour. Regional ADC measurements appeared representative of volumetric histogram data in this study.

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“…Diffusion-weighted imaging (DWI) has become established as a standard sequence in neuroradiology. It is extremely valuable in the assessment of tumour cellularity, differential diagnosis and treatment response and in identifying metastases [24][25][26][27]. We recommend 2D echo planar DWI sequence with at least 2 bvalues (b = 0 s/mm 2 and b = 1000 s /mm 2 ).…”

Section: Diffusion-weighted Imagingmentioning

confidence: 99%

European Society for Paediatric Oncology (SIOPE) MRI guidelines for imaging patients with central nervous system tumours

et al. 2021

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Introduction Standardisation of imaging acquisition is essential in facilitating multicentre studies related to childhood CNS tumours. It is important to ensure that the imaging protocol can be adopted by centres with varying imaging capabilities without compromising image quality. Materials and method An imaging protocol has been developed by the Brain Tumour Imaging Working Group of the European Society for Paediatric Oncology (SIOPE) based on consensus among its members, which consists of neuroradiologists, imaging scientists and paediatric neuro-oncologists. This protocol has been developed to facilitate SIOPE led studies and regularly reviewed by the imaging working group. Results The protocol consists of essential MRI sequences with imaging parameters for 1.5 and 3 Tesla MRI scanners and a set of optional sequences that can be used in appropriate clinical settings. The protocol also provides guidelines for early post-operative imaging and surveillance imaging. The complementary use of multimodal advanced MRI including diffusion tensor imaging (DTI), MR spectroscopy and perfusion imaging is encouraged, and optional guidance is provided in this publication. Conclusion The SIOPE brain tumour imaging protocol will enable consistent imaging across multiple centres involved in paediatric CNS tumour studies.

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Role of diffusion weighted imaging for differentiating cerebral pilocytic astrocytoma and ganglioglioma BRAF V600E-mutant from wild type

Cited by 17 publications

References 40 publications

Advanced Neuroimaging Approaches to Pediatric Brain Tumors

Advanced Neuroimaging Approaches to Pediatric Brain Tumors

Imaging characteristics of H3 K27M histone-mutant diffuse midline glioma in teenagers and adults

European Society for Paediatric Oncology (SIOPE) MRI guidelines for imaging patients with central nervous system tumours

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