Quantitative diffusion-weighted and dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging analysis of T2 hypointense lesion components in pediatric diffuse intrinsic pontine glioma

U. Löbel, J. Sedlacik, W. E. Reddick, Mehmet Kocak, Q. Ji, A. Broniscer, C. M. Hillenbrand, Zoltan Patay

Research output: Contribution to journalArticle

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Abstract

BACKGROUND AND PURPOSE: Focal anaplasia characterized by T2 hypointensity, signal-intensity enhancement on postcontrast T1-weighted MR imaging and restricted water diffusion has been reported in a patient with juvenile pilocytic astrocytoma. We identified T2HOF with these MR imaging characteristics in children with DIPG and hypothesized that these represent areas of focal anaplasia; and may, therefore, have increased perfusion properties and should be characterized by increased perfusion. Thus, we used DSC to investigate our hypothesis. MATERIALS AND METHODS: We retrospectively reviewed the baseline MR imaging scans of 86 patients (49 girls, 37 boys; median age, 6.1 years; range, 1.1-17.6 years) treated for DIPG at our hospital (2004-2009). T2HOF with the described MR imaging characteristics was identified in 10 patients. We used a region of interest-based approach to compare the ADC, FA, rCBV, rCBF, and rMTT of T2HOF with those of the typical T2HRT. RESULTS: The ADC of T2HOF with the specified MR imaging characteristics was significantly lower than that of T2HRT (range, 0.71-1.95 μm 2/ms versus 1.36-2.13 μm2/ms; P < .01); and the FA (range, 0.12-0.34 versus 0.07-0.24; P = .03) and rCBV (range, 0.4-2.62 versus 0.23-1.57; P = .01) values of T2HOFs were significantly higher. CONCLUSIONS: Our data suggest that T2HOF in DIPG may represent areas of focal anaplasia and underline the importance of regional, rather than global, tumor-field analysis. T2HOF may be the ideal target when stereotactic biopsy of tumors that present with an inhomogeneous T2 signal intensity is considered.

Original languageEnglish (US)
Pages (from-to)315-322
Number of pages8
JournalAmerican Journal of Neuroradiology
Volume32
Issue number2
DOIs
StatePublished - Feb 1 2011

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Anaplasia
Perfusion Imaging
Glioma
Pediatrics
Perfusion
Astrocytoma
Neoplasms
Biopsy
Water

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

Cite this

Quantitative diffusion-weighted and dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging analysis of T2 hypointense lesion components in pediatric diffuse intrinsic pontine glioma. / Löbel, U.; Sedlacik, J.; Reddick, W. E.; Kocak, Mehmet; Ji, Q.; Broniscer, A.; Hillenbrand, C. M.; Patay, Zoltan.

In: American Journal of Neuroradiology, Vol. 32, No. 2, 01.02.2011, p. 315-322.

Research output: Contribution to journalArticle

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title = "Quantitative diffusion-weighted and dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging analysis of T2 hypointense lesion components in pediatric diffuse intrinsic pontine glioma",
abstract = "BACKGROUND AND PURPOSE: Focal anaplasia characterized by T2 hypointensity, signal-intensity enhancement on postcontrast T1-weighted MR imaging and restricted water diffusion has been reported in a patient with juvenile pilocytic astrocytoma. We identified T2HOF with these MR imaging characteristics in children with DIPG and hypothesized that these represent areas of focal anaplasia; and may, therefore, have increased perfusion properties and should be characterized by increased perfusion. Thus, we used DSC to investigate our hypothesis. MATERIALS AND METHODS: We retrospectively reviewed the baseline MR imaging scans of 86 patients (49 girls, 37 boys; median age, 6.1 years; range, 1.1-17.6 years) treated for DIPG at our hospital (2004-2009). T2HOF with the described MR imaging characteristics was identified in 10 patients. We used a region of interest-based approach to compare the ADC, FA, rCBV, rCBF, and rMTT of T2HOF with those of the typical T2HRT. RESULTS: The ADC of T2HOF with the specified MR imaging characteristics was significantly lower than that of T2HRT (range, 0.71-1.95 μm 2/ms versus 1.36-2.13 μm2/ms; P < .01); and the FA (range, 0.12-0.34 versus 0.07-0.24; P = .03) and rCBV (range, 0.4-2.62 versus 0.23-1.57; P = .01) values of T2HOFs were significantly higher. CONCLUSIONS: Our data suggest that T2HOF in DIPG may represent areas of focal anaplasia and underline the importance of regional, rather than global, tumor-field analysis. T2HOF may be the ideal target when stereotactic biopsy of tumors that present with an inhomogeneous T2 signal intensity is considered.",
author = "U. L{\"o}bel and J. Sedlacik and Reddick, {W. E.} and Mehmet Kocak and Q. Ji and A. Broniscer and Hillenbrand, {C. M.} and Zoltan Patay",
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T1 - Quantitative diffusion-weighted and dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging analysis of T2 hypointense lesion components in pediatric diffuse intrinsic pontine glioma

AU - Löbel, U.

AU - Sedlacik, J.

AU - Reddick, W. E.

AU - Kocak, Mehmet

AU - Ji, Q.

AU - Broniscer, A.

AU - Hillenbrand, C. M.

AU - Patay, Zoltan

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N2 - BACKGROUND AND PURPOSE: Focal anaplasia characterized by T2 hypointensity, signal-intensity enhancement on postcontrast T1-weighted MR imaging and restricted water diffusion has been reported in a patient with juvenile pilocytic astrocytoma. We identified T2HOF with these MR imaging characteristics in children with DIPG and hypothesized that these represent areas of focal anaplasia; and may, therefore, have increased perfusion properties and should be characterized by increased perfusion. Thus, we used DSC to investigate our hypothesis. MATERIALS AND METHODS: We retrospectively reviewed the baseline MR imaging scans of 86 patients (49 girls, 37 boys; median age, 6.1 years; range, 1.1-17.6 years) treated for DIPG at our hospital (2004-2009). T2HOF with the described MR imaging characteristics was identified in 10 patients. We used a region of interest-based approach to compare the ADC, FA, rCBV, rCBF, and rMTT of T2HOF with those of the typical T2HRT. RESULTS: The ADC of T2HOF with the specified MR imaging characteristics was significantly lower than that of T2HRT (range, 0.71-1.95 μm 2/ms versus 1.36-2.13 μm2/ms; P < .01); and the FA (range, 0.12-0.34 versus 0.07-0.24; P = .03) and rCBV (range, 0.4-2.62 versus 0.23-1.57; P = .01) values of T2HOFs were significantly higher. CONCLUSIONS: Our data suggest that T2HOF in DIPG may represent areas of focal anaplasia and underline the importance of regional, rather than global, tumor-field analysis. T2HOF may be the ideal target when stereotactic biopsy of tumors that present with an inhomogeneous T2 signal intensity is considered.

AB - BACKGROUND AND PURPOSE: Focal anaplasia characterized by T2 hypointensity, signal-intensity enhancement on postcontrast T1-weighted MR imaging and restricted water diffusion has been reported in a patient with juvenile pilocytic astrocytoma. We identified T2HOF with these MR imaging characteristics in children with DIPG and hypothesized that these represent areas of focal anaplasia; and may, therefore, have increased perfusion properties and should be characterized by increased perfusion. Thus, we used DSC to investigate our hypothesis. MATERIALS AND METHODS: We retrospectively reviewed the baseline MR imaging scans of 86 patients (49 girls, 37 boys; median age, 6.1 years; range, 1.1-17.6 years) treated for DIPG at our hospital (2004-2009). T2HOF with the described MR imaging characteristics was identified in 10 patients. We used a region of interest-based approach to compare the ADC, FA, rCBV, rCBF, and rMTT of T2HOF with those of the typical T2HRT. RESULTS: The ADC of T2HOF with the specified MR imaging characteristics was significantly lower than that of T2HRT (range, 0.71-1.95 μm 2/ms versus 1.36-2.13 μm2/ms; P < .01); and the FA (range, 0.12-0.34 versus 0.07-0.24; P = .03) and rCBV (range, 0.4-2.62 versus 0.23-1.57; P = .01) values of T2HOFs were significantly higher. CONCLUSIONS: Our data suggest that T2HOF in DIPG may represent areas of focal anaplasia and underline the importance of regional, rather than global, tumor-field analysis. T2HOF may be the ideal target when stereotactic biopsy of tumors that present with an inhomogeneous T2 signal intensity is considered.

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