Journal of Neuro-Oncology

, Volume 86, Issue 3, pp 313–319

Conventional MRI cannot predict survival in childhood diffuse intrinsic pontine glioma

Clinical-patient studies

Abstract

Diffuse intrinsic pontine glioma (DIPG) of childhood has a dismal prognosis. Clinical trials of new agents are vital and it is essential that the correct endpoints and disease assessments are chosen. A retrospective review of magnetic resonance imaging (MRI) scanning in a pure population of DIPG was undertaken. Baseline diagnostic MRI findings included; local tumour extension in upper medulla (74%) or midbrain (62%), metastatic disease (3%), basilar artery encasement (82%), necrosis (33%), intratumoural haemorrhage (26%), hydrocephalus (23%) and dorsal exophytic component (18%). Post-treatment MRI scans demonstrated increases in; leptomeningeal metastatic disease (16%), cystic change/necrosis (48%), enhancement (72%) and intratumoural haemorrhage (32%). Response rates were calculated according to both RECIST (4%) and WHO (24%) criteria. No MRI parameter in either the diagnostic or response scans had prognostic significance. We recommend that currently primary endpoints for DIPG clinical trials should be overall or possibly progression free survival and that new advanced functional imaging techniques should be explored as possible surrogate markers for novel therapy activity rather than conventional MRI response criteria.

Keywords

Child Intratumoural haemorrhage Magnetic resonance imaging Prognosis Pontine glioma Survival 

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Copyright information

© Springer Science+Business Media, LLC. 2007

Authors and Affiliations

  • Darren Hargrave
    • 1
  • Nathaniel Chuang
    • 2
  • Eric Bouffet
    • 3
  1. 1.Paediatric Oncology UnitRoyal Marsden NHS Foundation TrustLondonUK
  2. 2.San Diego Imaging Medical GroupRady Children’s HospitalSan DiegoUSA
  3. 3.Brain Tumor programHospital for Sick ChildrenTorontoUSA

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