Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun 26;46(1):151.
doi: 10.1007/s10143-023-02068-3.

A multimodal imaging-based classification for pediatric diffuse intrinsic pontine gliomas

Changcun Pan  1 , Mingxin Zhang  1 , Xiong Xiao  1 , Lu Kong  1 , Yuliang Wu  1 , Xiaobin Zhao  2 , Tao Sun  1 , Peng Zhang  1 , Yibo Geng  1 , Pengcheng Zuo  1 , Yi Wang  1 , Xiaoou Li  1 , Guocan Gu  1 , Tian Li  1 , Zhen Wu  1 , Junting Zhang  1 , Liwei Zhang  3   4
Affiliations

A multimodal imaging-based classification for pediatric diffuse intrinsic pontine gliomas

Changcun Pan et al. Neurosurg Rev. .

Abstract

Object: Pediatric diffuse intrinsic pontine glioma (DIPG) is a radiologically heterogeneous disease entity, here we aim to establish a multimodal imaging-based radiological classification and evaluate the outcome of different treatment strategies under this classification frame.

Methods: This retrospective study included 103 children diagnosed with DIPGs between January 2015 and August 2018 in Beijing Tiantan Hospital (Beijing, China). Multimodal radiological characteristics, including conventional magnetic resonance imaging (MRI), diffuse tensor imaging/diffuse tensor tractography (DTI/DTT), and positron emission tomography (PET) were reviewed to construct the classification. The outcome of different treatment strategies was compared in each DIPG subgroup using Kaplan-Meier method (log-rank test) to determine the optimal treatment for specific DIPGs.

Results: Four radiological DIPG types were identified: Type A ("homocentric", n=13), Type B ("ventral", n=41), Type C ("eccentric", n=37), and Type D ("dorsal", n=12). Their treatment modalities were grouped as observation (43.7%), cytoreductive surgery (CRS) plus radiotherapy (RT) (24.3%), RT alone (11.7%), and CRS alone (20.4%). CRS+RT mainly fell into type C (29.7%), followed by type B1 (21.9%) and type D (50%). Overall, CRS+RT exhibited a potential survival advantage compared to RT alone, which was more pronounced in specific type, but this did not reach statistical significance, due to limited sample size and unbalanced distribution.

Conclusion: We proposed a multimodality imaging-based radiological classification for pediatric DIPG, which was useful for selecting optimal treatment strategies, especially for identifying candidates who may benefit from CRS plus RT. This classification opened a window into image-guided integrated treatment for pediatric DIPG.

Keywords: classification; cytoreductive surgery; diffuse intrinsic pontine glioma; multimodal imaging; prognosis.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Johung TB, Monje M (2017) Diffuse Intrinsic Pontine Glioma: New Pathophysiological Insights and Emerging Therapeutic Targets. Curr Neuropharmacol 15:88–97. https://doi.org/10.2174/1570159x14666160509123229 - DOI - PubMed - PMC
    1. Epstein F, McCleary EL (1986) Intrinsic brain-stem tumors of childhood: surgical indications. J Neurosurg 64:11–15. https://doi.org/10.3171/jns.1986.64.1.0011 - DOI - PubMed
    1. Frazier JL, Lee J, Thomale UW, Noggle JC, Cohen KJ, Jallo GI (2009) Treatment of diffuse intrinsic brainstem gliomas: failed approaches and future strategies. J Neurosurg Pediatr 3:259–269. https://doi.org/10.3171/2008.11.PEDS08281 - DOI - PubMed
    1. Freeman CR, Suissa S (1986) Brain stem tumors in children: results of a survey of 62 patients treated with radiotherapy. Int J Radiat Oncol Biol Phys 12:1823–1828. https://doi.org/10.1016/0360-3016(86)90325-1 - DOI - PubMed
    1. Hargrave D, Bartels U, Bouffet E (2006) Diffuse brainstem glioma in children: critical review of clinical trials. Lancet Oncol 7:241–248. https://doi.org/10.1016/S1470-2045(06)70615-5 - DOI - PubMed

LinkOut - more resources