Paediatric brain-stem gliomas: MRI, FDG-PET and histological grading correlation.
BACKGROUND
MRI and FDG-PET may predict the histological grading of paediatric brain-stem gliomas.


OBJECTIVE
To assess MRI findings and metabolic imaging using FDG-PET of brain-stem gliomas based on histological grading.


METHODS
Included in the study were 20 paediatric patients (age 3-14 years, mean 8.2 years) with brain-stem glioma (five glioblastomas, ten anaplastic astrocytomas and five low-grade astrocytomas). MR images were assessed for the anatomical site of tumour origin, focality, pattern of tumour growth, and enhancement.


RESULTS
All glioblastomas were located in the pons and showed diffuse pontine enlargement with focally exophytic features. Eight anaplastic astrocytomas were located in the pons and demonstrated diffuse pontine enlargement without exophytic features. Low-grade astrocytomas were located in the pons, midbrain or medulla and showed focally exophytic growth features and peripheral enhancement. In 12 patients in whom FDG-PET was undertaken, glioblastomas showed hypermetabolic or hypometabolic lesions, anaplastic astrocytomas showed no metabolic change or hypometabolic lesions and low-grade astrocytomas showed hypometabolism compared with the cerebellum.


CONCLUSIONS
MRI findings correlated well with histological grading of brain-stem gliomas and MRI may therefore predict the histological grading. FDG-PET may be helpful in differentiating between anaplastic astrocytoma and glioblastomas among high-grade tumours.
Kwon
Jong Won
JW
Department of Radiology, Seoul National University Hospital, 28, Yongon-Dong, Chongno-Gu, 110-744 Seoul, South Korea.
Kim
In-One
IO
Cheon
Jung-Eun
JE
Kim
Woo Sun
WS
Moon
Sung Gyu
SG
Kim
Tae Jung
TJ
Chi
Je Geun
JG
Wang
Kyu-Chang
KC
Chung
June Key
JK
Yeon
Kyung Mo
KM
D000293:Adolescent; D020295:Brain Stem Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D005910:Glioma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009367:Neoplasm Staging; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed / Q000379:methods
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18