Pediatric Posterior Fossa Medulloblastoma: The Role of Diffusion Imaging in Identifying Molecular Groups.
Apparent diffusion coefficient
diffusion-weighted imaging
medulloblastoma
molecular groups
posterior fossa tumors
Journal
Journal of neuroimaging : official journal of the American Society of Neuroimaging
ISSN: 1552-6569
Titre abrégé: J Neuroimaging
Pays: United States
ID NLM: 9102705
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
24
09
2019
revised:
13
02
2020
accepted:
05
03
2020
pubmed:
13
6
2020
medline:
16
2
2021
entrez:
13
6
2020
Statut:
ppublish
Résumé
The molecular groups WNT activated (WNT), Sonic hedgehog activated (SHH), group 3, and group 4 are biologically and clinically distinct forms of medulloblastoma. We evaluated apparent diffusion coefficient (ADC) values' utility in differentiating/predicting medulloblastoma groups at the initial diagnostic imaging evaluation and prior to surgery. We retrospectively measured the ADC values of the enhancing, solid portion of the tumor (EST) and of the whole tumor (WT) and performed Kruskal-Wallis testing to compare the absolute tumor ADC values and cerebellar and thalamic ratios of three medulloblastoma groups (WNT, SHH, and group 3/group 4 combined). Ninety-three children (65 males) were included. Fifty-seven children had group 3/group 4, 27 had SHH, and 9 had WNT medulloblastomas. The median absolute ADC values in the EST and WT were .719 × 10 ADC analysis of a tumor's contrast-enhancing solid portion may aid preoperative molecular classification/prediction of pediatric medulloblastomas and may facilitate optimal surgical treatment planning, reducing surgery-induced morbidity.
Sections du résumé
BACKGROUND AND PURPOSE
The molecular groups WNT activated (WNT), Sonic hedgehog activated (SHH), group 3, and group 4 are biologically and clinically distinct forms of medulloblastoma. We evaluated apparent diffusion coefficient (ADC) values' utility in differentiating/predicting medulloblastoma groups at the initial diagnostic imaging evaluation and prior to surgery.
METHODS
We retrospectively measured the ADC values of the enhancing, solid portion of the tumor (EST) and of the whole tumor (WT) and performed Kruskal-Wallis testing to compare the absolute tumor ADC values and cerebellar and thalamic ratios of three medulloblastoma groups (WNT, SHH, and group 3/group 4 combined).
RESULTS
Ninety-three children (65 males) were included. Fifty-seven children had group 3/group 4, 27 had SHH, and 9 had WNT medulloblastomas. The median absolute ADC values in the EST and WT were .719 × 10
CONCLUSION
ADC analysis of a tumor's contrast-enhancing solid portion may aid preoperative molecular classification/prediction of pediatric medulloblastomas and may facilitate optimal surgical treatment planning, reducing surgery-induced morbidity.
Substances chimiques
Hedgehog Proteins
0
Wnt Proteins
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
503-511Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR001079
Pays : United States
Informations de copyright
© 2020 American Society of Neuroimaging.
Références
Partap S, Curran EK, Propp JM, et al. Medulloblastoma incidence has not changed over time: a CBTRUS study. J Pediatr Hematol Oncol 2009;31:970-1.
McManamy CS, Lamont JM, Taylor Roger E. Morphophenotypic variation predicts clinical behavior in childhood non-desmoplastic medulloblastomas. J Neuropathol Exp Neurol 2003;62:627-32.
Pomeroy SL, Tamayo P, Gaasenbeek M, et al. Prediction of central nervous system embryonal tumour outcome based on gene expression. Nature 2002;415:436-42.
Northcott PA, Korshunov A, Witt H, et al. Medulloblastoma comprises four distinct molecular variants. J Clin Oncol 2011;29:1408-14.
Miranda Kuzan-Fischer C, Juraschka K, Taylor MD. Medulloblastoma in the molecular era. J Korean Neurosurg Soc 2018;61:292-301.
Taylor MD, Northcott PA, Korshunov A, et al. Molecular subgroups of medulloblastoma: the current consensus. Acta Neuropathol 2012;123:465-72.
Perreault S, Ramaswamy V, Achrol AS, Chao K, et al. MRI surrogates for molecular subgroups of medulloblastoma. AJNR Am J Neuroradiol 2014;35:1263-9.
Cavalli FMG, Remke M, Rampasek L, et al. Intertumoral heterogeneity within medulloblastoma subgroups. Cancer Cell 2017;31:737-54.e6.
Ellison DW, Dalton J, Kocak M, et al. Medulloblastoma: clinicopathological correlates of SHH, WNT, and non-SHH/WNT molecular subgroups. Acta Neuropathol 2011;121:381-96.
Poretti A, Meoded A, Thierry A G. Neuroimaging of pediatric posterior fossa tumors including review of the literature. J Magn Reson Imaging 2012;35:32-47.
Patay Z, DeSain LA, Hwang SN, et al. MR imaging characteristics of wingless-type-subgroup pediatric medulloblastoma. AJNR Am J Neuroradiol 2015;36:2386-93.
Poretti A, Meoded A, Cohen KJ, et al. Apparent diffusion coefficient of pediatric cerebellar tumors: a biomarker of tumor grade? Pediatr Blood Cancer 2013;60:2036-41.
Cho Y-J, Tsherniak A, Tamayo P, et al. Integrative genomic analysis of medulloblastoma identifies a molecular subgroup that drives poor clinical outcome. J Clin Oncol 2011;29:1424-30.
Ellison DW, Onilude OE, Lindsey JC, et al. β-Catenin status predicts a favorable outcome in childhood medulloblastoma: the United Kingdom Children's Cancer Study Group Brain Tumour Committee. J Clin Oncol 2005;23:7951-7.
Fattet S, Haberler C, Legoix P, et al. Beta-catenin status in paediatric medulloblastomas: correlation of immunohistochemical expression with mutational status, genetic profiles, and clinical characteristics. J Pathol 2009;218:86-94.
Gajjar A, Chintagumpala M, Ashley D, et al. Risk-adapted craniospinal radiotherapy followed by high-dose chemotherapy and stem-cell rescue in children with newly diagnosed medulloblastoma (St Jude Medulloblastoma-96): long-term results from a prospective, multicentre trial. Lancet Oncol 2006;7:813-20.
Robinson GW. Impact of tumor location on medulloblastoma subtyping and treatment. Pediatr Blood Cancer 2013;60:1393-4.
Huisman TA. Diffusion-weighted imaging: basic concepts and application in cerebral stroke and head trauma. Eur Radiol 2003;13:2283-97.
Gauvain KM, McKinstry RC, Mukherjee P, et al. Evaluating pediatric brain tumor cellularity with diffusion-tensor imaging. AJR Am J Roentgenol 2001;177:449-54.
Filippi CG, Lin DDM, Tsiouris Apostolos J. Diffusion-tensor MR imaging in children with developmental delay: preliminary findings. Radiology 2003;229:44-50.
Kono K, Inoue Y, Nakayama K, et al. The role of diffusion-weighted imaging in patients with brain tumors. AJNR Am J Neuroradiol 2001;22:1081-8.
Kool M, Koster J, Bunt J, et al. Integrated genomics identifies five medulloblastoma subtypes with distinct genetic profiles, pathway signatures and clinicopathological features. PLoS ONE 2008;3:e3088.
Bihan DL, Le Bihan D, Breton E, et al. MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders. Radiology 1986;161:401-7.
Liu H-Q, Yin X, Li Y, et al. MRI features in children with desmoplastic medulloblastoma. J Clin Neurosci 2012;19:281-5.
Pillai S, Singhal A, Byrne AT, et al. Diffusion-weighted imaging and pathological correlation in pediatric medulloblastomas - “they are not always restricted!”. Childs Nerv Syst 2011;27:1407-11.
Schob S, Beeskow A, Dieckow J, et al. Diffusion profiling of tumor volumes using a histogram approach can predict proliferation and further microarchitectural features in medulloblastoma. Childs Nerv Syst 2018;34:1651-6.
Albright AL, Leland Albright A, Wisoff Jeffrey H. Effects of medulloblastoma resections on outcome in children: a report from the Children's Cancer Group. Neurosurgery 1996;38:265-71.
Zeltzer PM, Boyett JM, Finlay JL, et al. Metastasis stage, adjuvant treatment, and residual tumor are prognostic factors for medulloblastoma in children: conclusions from the Children's Cancer Group 921 Randomized Phase III Study. J Clin Oncol 1999;17:832-45.
Thompson EM, Hielscher T, Bouffet E, et al. Prognostic value of medulloblastoma extent of resection after accounting for molecular subgroup: a retrospective integrated clinical and molecular analysis. Lancet Oncol 2016;17:484-95.
Gudrunardottir T, Sehested A, Juhler M, et al. Cerebellar mutism: definitions, classification and grading of symptoms. Childs Nerv Syst 2011;27:1361-3.