Diffusion-weighted and dynamic contrast-enhanced imaging as markers of clinical behavior in children with optic pathway glioma.
BACKGROUND
Optic pathway gliomas (OPGs) are common pediatric brain tumors that pose significant clinical challenges with regard to predicting which tumors are likely to become symptomatic and require treatment. These tumors can arise sporadically or in the context of the inherited cancer predisposition syndrome neurofibromatosis type 1 (NF1). Few studies have suggested biological or imaging markers that predict the clinical course of this disease.


OBJECTIVE
In this cross-sectional study, we hypothesized that the clinical behavior of OPGs in children can be differentiated by diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) MRI.


METHODS
A total of 27 children with OPG were studied using DW and DCE MRI protocols. Diffusivity and permeability were calculated and correlated with the clinical behavior the OPG.


RESULTS
Mean diffusivity values of 1.39 microm2/ms and mean permeability values of 2.10 ml/min per 100 cm3 of tissue were measured. Clinically aggressive OPGs had significantly higher mean permeability values (P = 0.05) than clinically stable tumors. In addition, there was a strong correlation between clinical aggressiveness and the absence of NF1 (P < 0.01).


CONCLUSIONS
These results suggest that DCE MRI might be a useful biomarker for clinically aggressive OPG, which should be confirmed in larger prospective longitudinal studies.
Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, WA, USA. sarah.jost@swedish.org
Sarah C
SC
Jost
Joseph W
JW
Ackerman
Joel R
JR
Garbow
Linda P
LP
Manwaring
David H
DH
Gutmann
Robert C
RC
McKinstry
D002199:Capillary Permeability; D002648:Child; D003287:Contrast Media; D003430:Cross-Sectional Studies; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D009897:Optic Chiasm / Q000187:drug effects / Q000473:pathology* / Q000601:surgery; D020339:Optic Nerve Glioma / Q000473:pathology* / Q000628:therapy; D011237:Predictive Value of Tests; D016896:Treatment Outcome
D003287:Contrast Media; D005682:Gadolinium