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Diffusion-weighted and dynamic contrast-enhanced imaging as markers of clinical behavior in children with optic pathway glioma

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Abstract

Background

Optic pathway gliomas (OPGs) are common pediatric brain tumors that pose significant clinical challenges with regard to predicting which tumors are likely to become symptomatic and require treatment. These tumors can arise sporadically or in the context of the inherited cancer predisposition syndrome neurofibromatosis type 1 (NF1). Few studies have suggested biological or imaging markers that predict the clinical course of this disease.

Objective

In this cross-sectional study, we hypothesized that the clinical behavior of OPGs in children can be differentiated by diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) MRI.

Materials and methods

A total of 27 children with OPG were studied using DW and DCE MRI protocols. Diffusivity and permeability were calculated and correlated with the clinical behavior the OPG.

Results

Mean diffusivity values of 1.39 μm2/ms and mean permeability values of 2.10 ml/min per 100 cm3 of tissue were measured. Clinically aggressive OPGs had significantly higher mean permeability values (P = 0.05) than clinically stable tumors. In addition, there was a strong correlation between clinical aggressiveness and the absence of NF1 (P < 0.01).

Conclusion

These results suggest that DCE MRI might be a useful biomarker for clinically aggressive OPG, which should be confirmed in larger prospective longitudinal studies.

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Acknowledgement

Partial support for this project was provided by Schnucks Markets Inc. to D.H.G.

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Authors and Affiliations

  1. Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, WA, USA

    Sarah C. Jost

  2. Department of Radiology, Washington University School of Medicine, 660 South Euclid Ave., Box 8131, St. Louis, MO, 63110, USA

    Joseph W. Ackerman, Joel R. Garbow & Robert C. McKinstry

  3. Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA

    Linda P. Manwaring & Robert C. McKinstry

  4. Department of Genetics and Genomic Medicine, Washington University School of Medicine, St. Louis, MO, USA

    Linda P. Manwaring

  5. Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA

    David H. Gutmann

  6. Alvin J. Siteman Cancer Center, St. Louis, MO, USA

    Joel R. Garbow & David H. Gutmann

Authors
  1. Sarah C. Jost
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  2. Joseph W. Ackerman
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  3. Joel R. Garbow
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  4. Linda P. Manwaring
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  5. David H. Gutmann
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  6. Robert C. McKinstry
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Corresponding author

Correspondence to Robert C. McKinstry.

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Jost, S.C., Ackerman, J.W., Garbow, J.R. et al. Diffusion-weighted and dynamic contrast-enhanced imaging as markers of clinical behavior in children with optic pathway glioma. Pediatr Radiol 38, 1293–1299 (2008). https://doi.org/10.1007/s00247-008-1003-x

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  • DOI: https://doi.org/10.1007/s00247-008-1003-x

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