TY - JOUR
T1 - MRI-Based Score to Recognize Thalamic Glioma Grade in Children
T2 - Morphology, Diffusion, and Arterial-Spin-Labeling Perfusion
AU - Plasse, Alexis
AU - Levy, Raphael
AU - Tauziède-Espariat, Arnault
AU - Agripnidis, Thibault
AU - Hak, Jean François
AU - Roux, Charles Joris
AU - Samoyeau, Thomas
AU - Ollitrault, Alexis
AU - Beccaria, Kevin
AU - Guida, Lelio
AU - Blauwblomme, Thomas
AU - Grill, Jacques
AU - Dufour, Christelle
AU - Guerrini-Rousseau, Léa
AU - Bourdeaut, Franck
AU - Doz, François
AU - Varlet, Pascale
AU - Boddaert, Nathalie
AU - Dangouloff-Ros, Volodia
N1 - Publisher Copyright:
© 2025 The Author(s). Pediatric Blood & Cancer published by Wiley Periodicals LLC.
PY - 2025/1/1
Y1 - 2025/1/1
N2 - 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.
AB - 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.
KW - Brain
KW - MRI
KW - children
KW - glioma
KW - thalamus
UR - http://www.scopus.com/inward/record.url?scp=105002379750&partnerID=8YFLogxK
U2 - 10.1002/pbc.31704
DO - 10.1002/pbc.31704
M3 - Article
AN - SCOPUS:105002379750
SN - 1545-5009
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
ER -