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. 2025 Jul;72(7):e31704.
doi: 10.1002/pbc.31704. Epub 2025 Apr 11.

MRI-Based Score to Recognize Thalamic Glioma Grade in Children: Morphology, Diffusion, and Arterial-Spin-Labeling Perfusion

Alexis Plasse  1   2   3 , Raphael Levy  1   2   3 , Arnault Tauziède-Espariat  4 , Thibault Agripnidis  5 , Jean-François Hak  5 , Charles-Joris Roux  1   2   3 , Thomas Samoyeau  1   2   3 , Alexis Ollitrault  1   2   3 , Kevin Beccaria  6   7 , Lelio Guida  6   7 , Thomas Blauwblomme  6   7 , Jacques Grill  8 , Christelle Dufour  8 , Léa Guerrini-Rousseau  8 , Franck Bourdeaut  7   9 , François Doz  7   9 , Pascale Varlet  4   10 , Nathalie Boddaert  1   2   3 , Volodia Dangouloff-Ros  2   3
Affiliations

MRI-Based Score to Recognize Thalamic Glioma Grade in Children: Morphology, Diffusion, and Arterial-Spin-Labeling Perfusion

Alexis Plasse et al. Pediatr Blood Cancer. 2025 Jul.

Abstract

Purpose: Thalamic gliomas are found predominantly in children and can be classified into two main types with different prognoses and management: diffuse midline glioma (DMG) H3K27-altered and low-grade glioma (LGG). Our aim was to find imaging features distinguishing these tumors and to develop a diagnostic score.

Patients and methods: A retrospective study spanning September 1999 to May 2021 involved pediatric patients with thalamic gliomas, categorized into H3K27-altered DMG and LGG groups. Preoperative imaging, including morphology, diffusion, and arterial-spin-labeling perfusion, was reviewed blindly and compared between the two groups. A diagnostic score was formulated based on significant findings. Results were validated using an internal and external validation cohort.

Results: Sixty-six patients were included (median age, 9 years; interquartile range [IQR] [5-13]; 38 girls) with 37 DMG H3K27-altered and 29 LGG. DMG H3K27-altered tumors exhibited larger volumes (median 64 cc, IQR [36-88] vs 26 cc, IQR [15-37], p < 0.001), greater heterogeneity in T2-weighted signal and enhancement (62% [22/37] vs 31% [9/29], p = 0.04, and 97% [32/33] vs 56% [15/27], p = 0.0008, respectively), lower minimum relative apparent diffusion coefficient (ADC) (0.92 (IQR [0.76-1.23]) vs 1.55 (IQR [1.40-1.72]), p < 0.001), and higher relative maximum cerebral blood flow (CBF) levels (2.08 (IQR [1.48-3.05]) vs 0.84 (IQR [0.45-1]), p < 0.001). A diagnostic score integrating tumor diameter, solid content predominance, relative ADC, and relative CBF achieved 100% sensitivity and specificity in distinguishing DMG H3K27-altered tumors from LGG (full score available for 36 patients), with good results in external and internal validation cohorts (12 patients).

Conclusion: The morphological, diffusion, and arterial spin labeling imaging characteristics of pediatric thalamic tumors enable excellent differentiation of DMG H3K27-altered and LGG.

Keywords: Brain; MRI; children; glioma; thalamus.

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References

    1. B. Bilginer, F. Narin, I. Işıkay, K. K. Oguz, F. Söylemezoglu, and N. Akalan, “Thalamic Tumors in Children,” Childs Nervous System 30 (2014): 1493–1498.
    1. C. Jones, M. A. Karajannis, D. T. W. Jones, et al., “Pediatric High‐Grade Glioma: Biologically and Clinically in Need of New Thinking,” Neuro‐Oncology 19 (2017): 153–161.
    1. G. Cinalli, D. T. Aguirre, G. Mirone, et al., “Surgical Treatment of Thalamic Tumors in Children,” Journal of Neurosurgery: Pediatrics 21 (2018): 247–257.
    1. M. W. Wagner, P. Jabehdar Maralani, J. Bennett, et al., “Brain Tumor Imaging in Adolescents and Young Adults: 2021 WHO Updates for Molecular‐Based Tumor Types,” Radiology 310 (2024): e230777.
    1. D. N. Louis, A. Perry, P. Wesseling, et al., “The 2021 WHO Classification of Tumors of the Central Nervous System: A Summary,” Neuro‐Oncology 23 (2021): 1231–1251.

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