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Journal of Neuro-Oncology

, Volume 116, Issue 3, pp 617–623 | Cite as

Surveillance imaging in children with malignant CNS tumors: low yield of spine MRI

  • Sébastien PerreaultEmail author
  • Robert M. Lober
  • Anne-Sophie Carret
  • Guohua Zhang
  • Linda Hershon
  • Jean-Claude Décarie
  • Hannes Vogel
  • Kristen W. Yeom
  • Paul G. Fisher
  • Sonia Partap
Clinical Study

Abstract

Magnetic resonance imaging (MRI) is routinely obtained in patients with central nervous system (CNS) tumors, but few studies have been conducted to evaluate this practice. We assessed the benefits of surveillance MRI and more specifically spine MRI in a contemporary cohort. We evaluated MRI results of children diagnosed with CNS tumors from January 2000 to December 2011. Children with at least one surveillance MRI following the diagnosis of medulloblastoma (MB), atypical teratoid rhabdoid tumor (ATRT), pineoblastoma (PB), supratentorial primitive neuroectodermal tumor, supratentorial high-grade glioma (World Health Organization grade III–IV), CNS germ cell tumors or ependymoma were included. A total of 2,707 brain and 1,280 spine MRI scans were obtained in 258 patients. 97 % of all relapses occurred in the brain and 3 % were isolated to the spine. Relapse was identified in 226 (8 %) brain and 48 (4 %) spine MRI scans. The overall rate of detecting isolated spinal relapse was 9/1,000 and 7/1,000 for MB patients. MRI performed for PB showed the highest rate for detecting isolated spinal recurrence with 49/1,000. No initial isolated spinal relapse was identified in patients with glioma, supratentorial primitive neuroectodermal tumor and ATRT. Isolated spinal recurrences are infrequent in children with malignant CNS tumors and the yield of spine MRI is very low. Tailoring surveillance spine MRI to patients with higher spinal relapse risk such as PB, MB with metastatic disease and within 3 years of diagnosis could improve allocation of resources without compromising patient care.

Keywords

MRI imaging Brain neoplasms Child Childhood medulloblastoma Pineoblastoma Primitive neuroectodermal tumor 

Notes

Acknowledgments

Sébastien Perreault is a Beverly and Bernard Wolfe Pediatric Neuro-Oncology fellow at Lucile Packard Children’s Hospital at Stanford University. He received Grants from Justine Lacoste Fundation and Fonds de Recherche en Santé du Québec (FRSQ) (Bourses de formation en recherche post-diplôme professionnel/Fellowship).

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

11060_2013_1347_MOESM1_ESM.docx (13 kb)
Supplementary material 1 (DOCX 12 kb)

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Sébastien Perreault
    • 1
    • 7
    Email author
  • Robert M. Lober
    • 2
  • Anne-Sophie Carret
    • 8
  • Guohua Zhang
    • 8
  • Linda Hershon
    • 8
  • Jean-Claude Décarie
    • 9
  • Hannes Vogel
    • 3
  • Kristen W. Yeom
    • 4
  • Paul G. Fisher
    • 1
    • 2
    • 5
    • 6
  • Sonia Partap
    • 1
  1. 1.Division of Child Neurology, Department of Neurology, Lucile Packard Children’s Hospital at StanfordStanford UniversityPalo AltoUSA
  2. 2.Department of Neurosurgery, Lucile Packard Children’s Hospital at StanfordStanford UniversityPalo AltoUSA
  3. 3.Department of Pathology, Lucile Packard Children’s Hospital at StanfordStanford UniversityPalo AltoUSA
  4. 4.Department of Radiology, Lucile Packard Children’s Hospital at StanfordStanford UniversityPalo AltoUSA
  5. 5.Department of Pediatrics, Lucile Packard Children’s Hospital at StanfordStanford UniversityPalo AltoUSA
  6. 6.Department of Human Biology, Lucile Packard Children’s Hospital at StanfordStanford UniversityPalo AltoUSA
  7. 7.Division of NeurologyCHU Sainte-JustineMontrealCanada
  8. 8.Division of Hematology-OncologyCHU Sainte-JustineMontrealCanada
  9. 9.Department of RadiologyCHU Sainte-JustineMontrealCanada

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