Systematic comparison of MRI findings in pediatric ependymoblastoma with ependymoma and CNS primitive neuroectodermal tumor not otherwise specified.
BACKGROUND
Ependymoblastoma (EBL), ependymoma (EP), and primitive neuroectodermal tumors of the central nervous system not otherwise specified (CNS-PNET NOS) are pediatric brain tumors that can be differentiated by histopathology in the clinical setting. Recently, we described specific MRI features of EBL. In this study, we compare standardized MRI characteristics of EBL with EP and CNS-PNET NOS in a series comprising 22 patients in each group.


METHODS
All 66 centrally reviewed cases were obtained from the database of the German multicenter HIT trials. We systematically analyzed the initial MRI scans at diagnosis according to standardized criteria, and paired comparison was performed for EBL and EP, as well as for EBL and CNS-PNET NOS.


RESULTS
We found differences between EBL and EP regarding age at diagnosis, MR signal intensity, tumor margin and surrounding edema, presence and size of cysts, and contrast enhancement pattern. Although MRI appearance of EBL shares many features with CNS-PNET NOS, we revealed significant differences in terms of age at diagnosis, tumor volume and localization, tumor margins, edema, and contrast enhancement.


CONCLUSIONS
This is the first study that systematically compares multiple parameters of MRI in pediatric EBL with findings in EP and CNS-PNET NOS. Although a definite differentiation by means of MRI alone might not be feasible in the individual case, we identify significant differences between these tumor entities.
Reference Center for Neuroradiology, University Hospital of Würzburg, Würzburg, Germany (J.N., C.S., B.A., M.W.-M.); Department of Radiology, University Hospital of Würzburg, Würzburg, Germany (J.N.); Department of Radiology, Pathology Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts (C.S., T.L.F.); Department of Neuropathology, Brain Tumor Reference Center, Bonn, Germany (T.P.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg- Eppendorf, Hamburg, Germany (C.F., K.v.H., S.R.); Division of Pediatric Oncology, Hematology and Hemostaseology, Department of Women's and Children's Health, University Hospital Leipzig, Leipzig, Germany (C.F.).
Johannes
J
Nowak
Reference Center for Neuroradiology, University Hospital of Würzburg, Würzburg, Germany (J.N., C.S., B.A., M.W.-M.); Department of Radiology, University Hospital of Würzburg, Würzburg, Germany (J.N.); Department of Radiology, Pathology Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts (C.S., T.L.F.); Department of Neuropathology, Brain Tumor Reference Center, Bonn, Germany (T.P.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg- Eppendorf, Hamburg, Germany (C.F., K.v.H., S.R.); Division of Pediatric Oncology, Hematology and Hemostaseology, Department of Women's and Children's Health, University Hospital Leipzig, Leipzig, Germany (C.F.).
Carolin
C
Seidel
Reference Center for Neuroradiology, University Hospital of Würzburg, Würzburg, Germany (J.N., C.S., B.A., M.W.-M.); Department of Radiology, University Hospital of Würzburg, Würzburg, Germany (J.N.); Department of Radiology, Pathology Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts (C.S., T.L.F.); Department of Neuropathology, Brain Tumor Reference Center, Bonn, Germany (T.P.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg- Eppendorf, Hamburg, Germany (C.F., K.v.H., S.R.); Division of Pediatric Oncology, Hematology and Hemostaseology, Department of Women's and Children's Health, University Hospital Leipzig, Leipzig, Germany (C.F.).
Torsten
T
Pietsch
Reference Center for Neuroradiology, University Hospital of Würzburg, Würzburg, Germany (J.N., C.S., B.A., M.W.-M.); Department of Radiology, University Hospital of Würzburg, Würzburg, Germany (J.N.); Department of Radiology, Pathology Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts (C.S., T.L.F.); Department of Neuropathology, Brain Tumor Reference Center, Bonn, Germany (T.P.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg- Eppendorf, Hamburg, Germany (C.F., K.v.H., S.R.); Division of Pediatric Oncology, Hematology and Hemostaseology, Department of Women's and Children's Health, University Hospital Leipzig, Leipzig, Germany (C.F.).
Balint
B
Alkonyi
Reference Center for Neuroradiology, University Hospital of Würzburg, Würzburg, Germany (J.N., C.S., B.A., M.W.-M.); Department of Radiology, University Hospital of Würzburg, Würzburg, Germany (J.N.); Department of Radiology, Pathology Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts (C.S., T.L.F.); Department of Neuropathology, Brain Tumor Reference Center, Bonn, Germany (T.P.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg- Eppendorf, Hamburg, Germany (C.F., K.v.H., S.R.); Division of Pediatric Oncology, Hematology and Hemostaseology, Department of Women's and Children's Health, University Hospital Leipzig, Leipzig, Germany (C.F.).
Taylor Laura
TL
Fuss
Reference Center for Neuroradiology, University Hospital of Würzburg, Würzburg, Germany (J.N., C.S., B.A., M.W.-M.); Department of Radiology, University Hospital of Würzburg, Würzburg, Germany (J.N.); Department of Radiology, Pathology Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts (C.S., T.L.F.); Department of Neuropathology, Brain Tumor Reference Center, Bonn, Germany (T.P.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg- Eppendorf, Hamburg, Germany (C.F., K.v.H., S.R.); Division of Pediatric Oncology, Hematology and Hemostaseology, Department of Women's and Children's Health, University Hospital Leipzig, Leipzig, Germany (C.F.).
Carsten
C
Friedrich
Reference Center for Neuroradiology, University Hospital of Würzburg, Würzburg, Germany (J.N., C.S., B.A., M.W.-M.); Department of Radiology, University Hospital of Würzburg, Würzburg, Germany (J.N.); Department of Radiology, Pathology Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts (C.S., T.L.F.); Department of Neuropathology, Brain Tumor Reference Center, Bonn, Germany (T.P.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg- Eppendorf, Hamburg, Germany (C.F., K.v.H., S.R.); Division of Pediatric Oncology, Hematology and Hemostaseology, Department of Women's and Children's Health, University Hospital Leipzig, Leipzig, Germany (C.F.).
Katja
K
von Hoff
Reference Center for Neuroradiology, University Hospital of Würzburg, Würzburg, Germany (J.N., C.S., B.A., M.W.-M.); Department of Radiology, University Hospital of Würzburg, Würzburg, Germany (J.N.); Department of Radiology, Pathology Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts (C.S., T.L.F.); Department of Neuropathology, Brain Tumor Reference Center, Bonn, Germany (T.P.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg- Eppendorf, Hamburg, Germany (C.F., K.v.H., S.R.); Division of Pediatric Oncology, Hematology and Hemostaseology, Department of Women's and Children's Health, University Hospital Leipzig, Leipzig, Germany (C.F.).
Stefan
S
Rutkowski
Reference Center for Neuroradiology, University Hospital of Würzburg, Würzburg, Germany (J.N., C.S., B.A., M.W.-M.); Department of Radiology, University Hospital of Würzburg, Würzburg, Germany (J.N.); Department of Radiology, Pathology Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts (C.S., T.L.F.); Department of Neuropathology, Brain Tumor Reference Center, Bonn, Germany (T.P.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg- Eppendorf, Hamburg, Germany (C.F., K.v.H., S.R.); Division of Pediatric Oncology, Hematology and Hemostaseology, Department of Women's and Children's Health, University Hospital Leipzig, Leipzig, Germany (C.F.).
Monika
M
Warmuth-Metz
D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D004806:Ependymoma / Q000473:pathology*; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D018242:Neuroectodermal Tumors, Primitive / Q000473:pathology*
CNS-PNET NOS; MRI; ependymoblastoma; ependymoma; magnetic resonance imaging