Abstract
Introduction
Advanced magnetic resonance imaging (MRI) techniques is an umbrella term that includes diffusion (DWI) and diffusion tensor (DTI), perfusion (PWI), spectroscopy (MRS), and functional (fMRI) imaging. These advanced modalities have improved the imaging of brain tumors and provided valuable additional information for treatment planning. Despite abundant literature on advanced MRI techniques in adult brain tumors, few reports exist for pediatric brain ones, potentially because of technical challenges.
Review of the literature
The authors review techniques and clinical applications of DWI, PWI, MRS, and fMRI, in the setting of pediatric hemispheric low-grade gliomas.
Personal experience
The authors propose their personal experience to highlight benefits and limits of advanced MR imaging in diagnosis, grading, and presurgical planning of pediatric hemispheric low-grade gliomas.
Discussion
Advanced techniques should be used as complementary tools to conventional MRI, and in theory, the combined use of the three techniques should ensure achieving the best results in the diagnosis of hemispheric low-grade glioma and in presurgical planning to maximize tumor resection and preserve brain function.
Future perspectives
In the setting of pediatric neurooncology, these techniques can be used to distinguish low-grade from high-grade tumor. However, these methods have to be applied on a large scale to understand their real potential and clinical relapse, and further technical development is required to reduce the excessive scan times and other technical limitations.
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References
Young GS (2007) Advanced MRI of adult brain tumors. Neurol Clin 25(4):947–973
Sievert AJ, Fisher MJ (2009) Pediatric low-grade gliomas. J Child Neurol 24(11):1397–1408
Saunders DE, Thompson C, Gunny R, Jones R, Cox T, Chong WK (2007) Magnetic resonance imaging protocols for pediatric neuroradiology. Pediatr Radiol 37(8):789–797
Panigrahy A, Blüml S (2009) Neuroimaging of pediatric brain tumors: from basic to advanced magnetic resonance imaging (MRI). J Child Neurol 24(11):1343–1365
Ho CY, Cardinal JS, Kamer AP, Kralik SF (2015) Relative cerebral blood volume from dynamic susceptibility contrast perfusion in the grading of pediatric primary brain tumors. Neuroradiology 57(3):299–306
Yeom KW, Mitchell LA, Lober RM, Barnes PD, Vogel H, Fisher PG, Edwards MS (2014) Arterial spin-labeled perfusion of pediatric brain tumors. AJNR Am J Neuroradiol 35(2):395–401
Law M, Yang S, Babb JS, et al. (2004) Comparison of cerebral blood volume and vascular permeability from dynamic susceptibility contrast-enhanced perfusion MR imaging with glioma grade. Am J Neuroradiol 25:746–755
Caulo M, Panara V, Tortora D, et al. (2014) Data-driven grading of brain gliomas: a multiparametric MR imaging study. Radiology 272(2):494–503
Roy B, Gupta RK, Maudsley AA, et al. (2013) Utility of multiparametric 3 T MRI for glioma characterization. Neuroradiology 5(55):603–613
Cha S, Lupo JM, Chen MH, et al. (2007) Differentiation of glioblastoma multiforme and single brain metastasis by peak height and percentage of signal intensity recovery derived from dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging. Am J Neuroradiol 28:1078–1084
Boria MJ, Plaza MJ, Altman N, Saigal G (2013) Conventional and advanced MRI features of pediatric intracranial tumors: supratentorial tumors. AJR Am J Roentgenol 200(5):W483–W503
Cebeci H, Aydin O, Ozturk-Isik E, Gumus C, Inecikli F, Bekar A, Kocaeli H, Hakyemez B (2014) Assesment of perfusion in glial tumors with arterial spin labeling; comparison with dynamic susceptibility contrast method. Eur J Radiol 83(10):1914–1919
Ball WS Jr, Holland SK (2001) Perfusion imaging in the pediatric patient. Magn Reson Imaging Clin N Am 9(1):207–230
Ho CY, Cardinal JS, Kamer AP, Lin C, Kralik SF (2016) Contrast leakage patterns from dynamic susceptibility contrast perfusion MRI in the grading of primary pediatric brain tumors. AJNR Am J Neuroradiol 37(3):544–551
Lefranc M, Monet P, Desenclos C, Peltier J, Fichten A, Toussaint P, Sevestre H, Deramond H, Le Gars D (2012) Perfusion MRI as a neurosurgical tool for improved targeting in stereotactic tumor biopsies. Stereotact Funct Neurosurg 90(4):240–247
Chaskis C, Stadnik T, Michotte A, Van Rompaey K, D’Haens J (2006) Prognostic value of perfusion-weighted imaging in brain glioma: a prospective study. Acta Neurochir 148(3):277–285 discussion 285
Essig M, Shiroishi MS, Nguyen TB, Saake M, Provenzale JM, Enterline D, Anzalone N, Dörfler A, Rovira A, Wintermark M, Law M (2013) Perfusion MRI: the five most frequently asked technical questions. AJR Am J Roentgenol 200(1):24–34
Schneider JF, Viola A, Confort-Gouny S, Ayunts K, Le Fur Y, Viout P, et al. (2007) Infratentorial pediatric brain tumors: the value of new imaging modalities. J Neuroradiol 34(1):49–58
Porto L, Jurcoane A, Schwabe D, Kieslich M, Hattingen E (2013) Differentiation between high and low grade tumours in paediatric patients by using apparent diffusion coefficients. Eur J Paediatr Neurol 17(3):302–307
Rumboldt Z, Camacho DL, Lake D, Welsh CT, Castillo M (2006) Apparent diffusion coefficients for differentiation of cerebellar tumors in children. AJNR Am J Neuroradiol 27(6):1362–1369
Jaremko JL, Jans LB, Coleman LT, Ditchfield MR (2010) Value and limitations of diffusion-weighted imaging in grading and diagnosis of pediatric posterior fossa tumors. AJNR Am J Neuroradiol 31(9):1613–1616
Schneider JF, Confort-Gouny S, Viola A, Le Fur Y, Viout P, Bennathan M, et al. (2007) Multiparametric differentiation of posterior fossa tumors in children using diffusion-weighted imaging and short echo-time 1H-MR spectroscopy. J Magn Reson Imaging 26(6):1390–1398
Poretti A, Meoded A, Huisman TA (2012) Neuroimaging of pediatric posterior fossa tumors including review of the literature. J Magn Reson Imaging 35(1):32–47
Peet AC, Lateef S, MacPherson L, Natarajan K, Sgouros S, Grundy RG (2007) Short echo time 1H magnetic resonance spectroscopy of childhood brain tumours. Childs Nerv Syst 23(2):163–169
Peet AC, Arvanitis TN, Auer DP, Davies NP, Hargrave D, Howe FA, Jaspan T, Leach MO, Macarthur D, MacPherson L, Morgan PS, Natarajan K, Payne GS, Saunders D, Grundy RG, Functional Imaging Group CCLG (2008) The value of magnetic resonance spectroscopy in tumour imaging. Arch Dis Child 93(9):725–727
Zakrzewski K, Kubicki M, Polis L, Nowosławska E, Liberski PP (1999) Proton magnetic resonance spectroscopy of primary pediatric brain tumors: neuropathological correlation. Folia Neuropathol 37(3):148–151
Barker PB (2001) N-acetyl aspartate—a neuronal marker? Ann Neurol 49(4):423–424
Panigrahy A, Krieger MD, Gonzalez-Gomez I, et al. (2006) Quantitative short echo time 1H-MR spectroscopy of untreated pediatric brain tumors: preoperative diagnosis and characterization. AJNR Am J Neuroradiol 27(3):560–572
Warren KE (2004) NMR spectroscopy and pediatric brain tumors. Oncologist 9(3):312–318
Shiroishi MS, Panigrahy A, Moore KR, Nelson MD Jr, Gilles FH, Gonzalez-Gomez I, Blüml S (2015) Combined MRI and MRS improves pre-therapeutic diagnoses of pediatric brain tumors over MRI alone. Neuroradiology 57(9):951–956
Porto L, Kieslich M, Franz K, Lehrbecher T, Pilatus U, Hattingen E (2010) Proton magnetic resonance spectroscopic imaging in pediatric low-grade gliomas. Brain Tumor Pathol 27(2):65–70
Rossi A, Garrè ML, Ravegnani M, Nozza P, Abbruzzese A, Giangaspero F, Tortori-Donati P (2008) Bilateral germinoma of the basal ganglia. Pediatric blood. Cancer 50(1):177–179
Bizzi A, Blasi V, Falini A, Ferroli P, Cadioli M, Danesi U, Aquino D, Marras C, Caldiroli D, Broggi G (2008) Presurgical functional MR imaging of language and motor functions: validation with intraoperative electrocortical mapping. Radiology 248(2):579–589
Petrella JR, Shah LM, Harris KM, Friedman AH, George TM, Sampson JH, Pekala JS, Voyvodic JT (2006) Preoperative functional MR imaging localization of language and motor areas: effect on therapeutic decision making in patients with potentially resectable brain tumors. Radiology 240(3):793–802
Ogawa S, Lee TM, Kay AR, Tank DW (1990) Brain magnetic resonance imaging with contrast dependent on blood oxygenation. Proc Natl Acad Sci U S A 87(24):9868–9872
Caulo M, Esposito R, Mantini D, Briganti C, Sestieri C, Mattei PA, Colosimo C, Romani GL, Tartaro A (2011) Comparison of hypothesis- and a novel hybrid data/hypothesis-driven method of functional MR imaging analysis in patients with brain gliomas. AJNR Am J Neuroradiol 32(6):1056–1064
Albright AL, Sposto R, Holmes E, Zeltzer PM, Finlay JL, Wisoff JH, Berger MS, Packer RJ, Pollack IF (2000) Correlation of neurosurgical subspecialization with outcomes in children with malignant brain tumors. Neurosurgery 47(4):879–885
Souweidanea MM, Kim KHS, McDowall R, Ruge MI, Lis E, Krol G, Hirsch J (1999) Brain mapping in sedated infants and young children with passive-functional magnetic resonance imaging. Pediatr Neurosurg 30:86–92
Dueck MH, Petzke F, Gerbershagen HJ, Paul M, Heßelmann V, Girnus R, Krug B, Sorger B, Goebel R, Lehrke R, Sturm V, Boerner U (2005) Propofol attenuates responses of the auditory cortex to acoustic stimulation in a dose-dependent manner: a fMRI study. Acta Anaesthesiol Scand 49(6):784–791
Ogg RJ, Laningham FH, Clarke D, et al. (2009) Passive range of motion functional magnetic resonance imaging localizing sensorimotor cortex in sedated children. J Neurosurg Pediatrics 4:317–322
Suarez RO, Taimouri V, Boyer K, Vega C, Rotenberg A, Madsen JR, Loddenkemper T, Duffy FH, Prabhu SP, Warfield SK (2014) Passive fMRI mapping of language function for pediatric epilepsy surgical planning: validation using Wada, ECS, and FMAER. Epilepsy Res 108(10):1874–1888
Tie Y, Rigolo L, Norton IH, Huang RY, Wu W, Orringer D, Mukundan S Jr, Golby AJ (2014) Defining language networks from resting-state fMRI for surgical planning: a feasibility study. Hum Brain Mapp 35(3):1018–1030
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Gaudino, S., Russo, R., Verdolotti, T. et al. Advanced MR imaging in hemispheric low-grade gliomas before surgery; the indications and limits in the pediatric age. Childs Nerv Syst 32, 1813–1822 (2016). https://doi.org/10.1007/s00381-016-3142-y
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DOI: https://doi.org/10.1007/s00381-016-3142-y