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Original Paper

Can Multiparametric MRI and FDG-PET Predict Outcome in Diffuse Brainstem Glioma? A Report from a Prospective Phase-II Study

Goda J.S.a · Dutta D.a · Raut N.a · Juvekar S.L.b · Purandare N.c · Rangarajan V.c · Arora B.d · Gupta T.a · Kurkure P.d · Jalali R.a

Author affiliations

Departments of aRadiation Oncology, bRadiodiagnosis, cBio-Imaging and dPediatric Oncology, Neuro-Oncology Disease Management Group, Tata Memorial Centre, Mumbai, India

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Pediatr Neurosurg 2013;49:274-281

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 09, 2014
Accepted: July 20, 2014
Published online: September 25, 2014
Issue release date: November 2014

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 4

ISSN: 1016-2291 (Print)
eISSN: 1423-0305 (Online)

For additional information: https://www.karger.com/PNE

Abstract

Purpose: To study the impact of multiparametric MRI and 18F-FDG-PET on the outcome of children with diffuse intrinsic pontine gliomas (DIPG). Materials and Methods: Imaging data from a phase-II prospective therapeutic study in children with newly diagnosed DIPG were considered for evaluation. They included baseline MRI with contrast enhancement before treatment. Functional imaging included MR spectroscopy, MR perfusion and FDG-PET studies. All patients (n = 20) had baseline MRI and 11 patients had FDG-PET. Response was assessed by MRI and PET 4 weeks after therapy. Baseline imaging findings were correlated with survival. Presence or absence of adverse parameters on MRI (heterogeneous contrast enhancement, hyperperfusion or increased choline:NAA ratio) was used to develop a cumulative radiological prognostic index (RPI). Sensitivity and specificity of each imaging modality in tumour grading was estimated. Results: The cumulative RPI was able to classify the patients into different grades and was predictive of overall survival (p = 0.02). MR perfusion also predicted survival (p = 0.039). Sensitivity and specificity of MRI and FDG-PET to detect low-grade gliomas were low to moderate (33-66%), but moderate to high in detecting high-grade gliomas (50-100%). Baseline FDG uptake on PET scan did not correlate with survival (p = 0.7). Conclusions: Cumulative RPI was able to classify tumours into different grades and predicted clinical outcome. At baseline, MR hyperperfusion indicated a shorter survival for DIPG patients. Sensitivity and specificity of imaging modalities to detect low-grade gliomas were poor.

© 2014 S. Karger AG, Basel


References

  1. Leach PA, Estlin EJ, Coope DJ, Thorne JA, Kamaly-Asl ID: Diffuse brainstem gliomas in children: should we or shouldn't we biopsy? Br J Neurosurg 2008;22:619-624.
  2. Rao P: Role of MRI in paediatric neurooncology. Eur J Radiol 2008;68:259-270.
  3. Jallo GI, Biser-Rohrbaugh A, Freed D: Brainstem gliomas. Childs Nerv Syst 2004;20:143-153.
  4. Rubin G, Michowitz S, Horev G, et al: Pediatric brain stem gliomas: an update. Childs Nerv Syst 1998;14:167-173.
  5. Lesniak MS, Klem JM, Weingart J, Carson BS Sr: Surgical outcome following resection of contrast-enhanced pediatric brainstem gliomas. Pediatr Neurosurg 2003;39:314-322.
  6. Treves ST, Chugani HT, Bourgeois BFD: Central nervous system; in Treves ST (ed): Pediatric Nuclear Medicine/PET, ed 3. New York, Springer, 2007, pp 30-31.
    External Resources
  7. Bruggers CS, Friedman HS, Fuller GN, et al: Comparison of serial PET and MRI scans in a pediatric patient with a brainstem glioma. Med Pediatr Oncol 1993;21:301-306.
  8. Padma MV, Said S, Jacobs M, et al: Prediction of pathology and survival by FDG PET in gliomas. J Neurooncol 2003;64:227-237.
  9. Delbeke D, Meyerowitz C, Lapidus RL, et al: Optimal cutoff levels of F-18 fluorodeoxyglucose uptake in the differentiation of low-grade from high-grade brain tumors with PET. Radiology 1995;195:47-52.
  10. Kwon JW, Kim IO, Cheon JE, et al: Paediatric brain-stem gliomas: MRI, FDG-PET and histological grading correlation. Pediatr Radiol 2006;36:959-964.
  11. Pirotte BJ, Lubansu A, Massager N, Wikler D, Goldman S, Levivier M: Results of positron emission tomography guidance and reassessment of the utility of and indications for stereotactic biopsy in children with infiltrative brainstem tumors. J Neurosurg 2007;107:392-399.
  12. Poussaint TY, Phillips PC, Vajapeyam S, et al: The Neuroimaging Center of the Pediatric Brain Tumor Consortium-collaborative neuroimaging in pediatric brain tumor research: a work in progress. AJNR Am J Neuroradiol 2007;28:603-607.
    External Resources
  13. Jalali R, Raut N, Arora B, et al: Prospective evaluation of radiotherapy with concurrent and adjuvant temozolomide in children with newly diagnosed diffuse intrinsic pontine glioma. Int J Radiat Oncol Biol Phys 2010;77:113-118.
  14. Hargrave D, Bartels U, Bouffet E: Diffuse brainstem glioma in children: critical review of clinical trials. Lancet Oncol 2006;7:241-248.
  15. Jennings MT, Freeman ML, Murray MJ: Strategies in the treatment of diffuse pontine gliomas: the therapeutic role of hyperfractionated radiotherapy and chemotherapy. J Neurooncol 1996;28:207-222.
  16. Jennings MT, Sposto R, Boyett JM, et al: Preradiation chemotherapy in primary high-risk brainstem tumors: phase II study CCG-9941 of the Children's Cancer Group. J Clin Oncol 2002;20:3431-3437.
  17. Mandell LR, Kadota R, Freeman C, et al: There is no role for hyperfractionated radiotherapy in the management of children with newly diagnosed diffuse intrinsic brainstem tumors: results of a Pediatric Oncology Group phase III trial comparing conventional versus hyperfractionated radiotherapy. Int J Radiat Oncol Biol Phys 1999;43:959-964.
    External Resources
  18. Dunkel IJ, Garvin JH Jr, Goldman S, et al: High dose chemotherapy with autologous bone marrow rescue for children with diffuse pontine brain stem tumors. Children's Cancer Group. J Neurooncol 1998;37:67-73.
  19. Yamasaki F, Kurisu K, Kajiwara Y, et al: Magnetic resonance spectroscopic detection of lactate is predictive of a poor prognosis in patients with diffuse intrinsic pontine glioma. Neuro Oncol 2011;13:791-801.
  20. Zukotynski KA, Fahey FH, Vajapeyam S, et al: Exploratory evaluation of MR permeability with 18F-FDG PET mapping in pediatric brain tumors: a report from the Pediatric Brain Tumor Consortium. J Nucl Med 2013;54:1237-1243.
  21. Hipp SJ, Steffen-Smith E, Hammoud D, Shih JH, Bent R, Warren KE: Predicting outcome of children with diffuse intrinsic pontine gliomas using multiparametric imaging. Neuro Oncol 2011;13:904-909.
  22. Dellaretti M, Reyns N, Touzet G, et al: Diffuse brainstem glioma: prognostic factors. J Neurosurg 2012;117:810-814.
  23. Rosenfeld A, Etzl M, Bandy D, et al: Use of positron emission tomography in the evaluation of diffuse intrinsic brainstem gliomas in children. J Pediatr Hematol Oncol 2011;33:369-373.
  24. Singhal T, Narayanan TK, Jacobs MP, Bal C, Mantil JC: 11C-methionine PET for grading and prognostication in gliomas: a comparison study with 18F-FDG PET and contrast enhancement on MRI. J Nucl Med 2012;53:1709-1715.
  25. Gilbertson RJ, Hill DA, Hernan R, et al: ERBB1 is amplified and overexpressed in high-grade diffusely infiltrative pediatric brain stem glioma. Clin Cancer Res 2003;9:3620-3624.
    External Resources
  26. Narayana A, Kunnakkat S, Chacko-Mathew J, et al: Bevacizumab in recurrent high-grade pediatric gliomas. Neuro Oncol 2010;12:985-990.
  27. Lonser RR, Warren KE, Butman JA, et al: Real-time image-guided direct convective perfusion of intrinsic brainstem lesions. Technical note. J Neurosurg 2007;107:190-197.
  28. Levivier M, Massager N, Brotchi J: Management of mass lesions of the brain stem. Crit Rev Neurosurg 1998;8:338-345.
    External Resources
  29. Rachinger W, Grau S, Holtmannspotter M, Herms J, Tonn JC, Kreth FW: Serial stereotactic biopsy of brainstem lesions in adults improves diagnostic accuracy compared with MRI only. J Neurol Neurosurg Psychiatry 2009;80:1134-1139.
  30. Chen HJ, Panigrahy A, Dhall G, Finlay JL, Nelson MD Jr, Bluml S: Apparent diffusion and fractional anisotropy of diffuse intrinsic brain stem gliomas. AJNR Am J Neuroradiol 2010;31:1879-1885.
  31. De Witte O, Levivier M, Violon P, et al: Prognostic value positron emission tomography with [18F]fluoro-2-deoxy-D-glucose in the low-grade glioma. Neurosurgery 1996;39:470-476; discussion 476-477.
  32. Zukotynski KA, Fahey FH, Kocak M, et al: Evaluation of 18F-FDG PET and MRI associations in pediatric diffuse intrinsic brain stem glioma: a report from the Pediatric Brain Tumor Consortium. J Nucl Med 2011;52:188-195.
  33. Salmaggi A, Fariselli L, Milanesi I, et al: Natural history and management of brainstem gliomas in adults. A retrospective Italian study. J Neurol 2008;255:171-177.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 09, 2014
Accepted: July 20, 2014
Published online: September 25, 2014
Issue release date: November 2014

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 4

ISSN: 1016-2291 (Print)
eISSN: 1423-0305 (Online)

For additional information: https://www.karger.com/PNE


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