Abstract
Diffuse intrinsic pontine gliomas (DIPG) are unique in pediatric neuro-oncology as they are inoperable and rarely being biopsied. They are a relatively clean tumor group to be studied with MR spectroscopy because lesions are always in the same region, generally large and homogeneous, and MR studies are technically not compromised by biopsies or surgery. These tumors are well suited for longitudinal studies to evaluate metabolic changes over the disease course. The absence of tissue samples, unfortunately, also means that definitive correlation between physiological features and tissue biology and histology is not possible. In this chapter, an overview of the MR spectroscopic features of DIPG at baseline and at follow-up is given.
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References
Cohen ME, Duffner PK, Heffner RR, Lacey DJ, Brecher M. Prognostic factors in brainstem gliomas. Neurology. 1986;36(5):602–5.
Albright AL, Guthkelch AN, Packer RJ, Price RA, Rourke LB. Prognostic factors in pediatric brain-stem gliomas. J Neurosurg. 1986;65(6):751–5.
Halperin EC, Wehn SM, Scott JW, Djang W, Oakes WJ, Friedman HS. Selection of a management strategy for pediatric brainstem tumors. Med Pediatr Oncol. 1989;17(2):117–26.
Freeman CR, Farmer JP. Pediatric brain stem gliomas: a review. Int J Radiat Oncol Biol Phys. 1998;40(2):265–71.
Farmer JP, Montes JL, Freeman CR, Meagher-Villemure K, Bond MC, O’Gorman AM. Brainstem gliomas. A 10-year institutional review. Pediatr Neurosurg. 2001;34(4):206–14.
Nelson Jr MD, Soni D, Baram TZ. Necrosis in pontine gliomas: radiation induced or natural history? Radiology. 1994;191(1):279–82.
Yoshimura J, Onda K, Tanaka R, Takahashi H. Clinicopathological study of diffuse type brainstem gliomas: analysis of 40 autopsy cases. Neurol Med Chir (Tokyo). 2003;43(8):375–82. discussion 382.
Fischbein NJ, Prados MD, Wara W, Russo C, Edwards MS, Barkovich AJ. Radiologic classification of brain stem tumors: correlation of magnetic resonance imaging appearance with clinical outcome. Pediatr Neurosurg. 1996;24(1):9–23.
Matson D. Neurosurgery of infancy and childhood. Springfield, Il: CC. Thomas; 1969. p. 469–77.
Jallo GI, Biser-Rohrbaugh A, Freed D. Brainstem gliomas. Childs Nerv Syst. 2004;20(3):143–53.
Laprie A, Pirzkall A, Haas-Kogan DA, et al. Longitudinal multivoxel MR spectroscopy study of pediatric diffuse brainstem gliomas treated with radiotherapy. Int J Radiat Oncol Biol Phys. 2005; 62(1):20–31.
Curless RG, Bowen BC, Pattany PM, Gonik R, Kramer DL. Magnetic resonance spectroscopy in childhood brainstem tumors. Pediatr Neurol. 2002;26(5):374–8.
Panigrahy A, Nelson Jr MD, Finlay JL, et al. Metabolism of diffuse intrinsic brainstem gliomas in children. Neuro Oncol. 2008;10(1):32–44.
Thakur SB, Karimi S, Dunkel IJ, Koutcher JA, Huang W. Longitudinal MR spectroscopic imaging of pediatric diffuse pontine tumors to assess tumor aggression and progression. AJNR Am J Neuroradiol. 2006;27(4):806–9.
Mandell LR, Kadota R, Freeman C, et al. There is no role for hyperfractionated radiotherapy in the management of children with newly diagnosed diffuse intrinsic brainstem tumors: results of a Pediatric Oncology Group phase III trial comparing conventional vs. hyperfractionated radiotherapy. Int J Radiat Oncol Biol Phys. 1999;43(5):959–64.
Pan E, Prados M. Brainstem gliomas. In: Gupta N, Haas-Kogen D, Banerjee A, editors. Pediatric CNS tumors, vol. 3. Berlin, Heidelberg, New York: Springer; 2004. p. 49–61.
Hargrave D, Bartels U, Bouffet E. Diffuse brainstem glioma in children: critical review of clinical trials. Lancet Oncol. 2006;7(3):241–8.
Panigrahy A, Finlay J, Dhall G, Krieger M, Nelson M, Bluml S. Post-therapeutic metabolic changes in diffuse intrinsic brain stem glioma: initial experience. Neuro-Oncology, Abstracts from the Thirteenth International Symposium on Pediatric Neuro-Oncology (ISPNO). 2008:393.
Panigrahy A, Krieger MD, Gonzalez-Gomez I, et al. Quantitative short echo time 1 H-MR spectroscopy of untreated pediatric brain tumors: preoperative diagnosis and characterization. AJNR Am J Neuroradiol. 2006;27(3):560–72.
Jackson HA, Panigrahy A, Lui X, Nelson M, D, Blüml S. Quantitative short echo time1H magnetic resonance spectroscopy of pediatric pontine gliomas: diagnosis and characterization. Paper presented at: Western Neuroradiological Society2005; Carlsbad, CA.
Dirks PB, Jay V, Becker LE, et al. Development of anaplastic changes in low-grade astrocytomas of childhood. Neurosurgery. 1994;34(1):68–78.
Seymour ZA, Panigrahy A, Finlay JL, Nelson Jr MD, Bluml S. Citrate in pediatric CNS tumors? AJNR Am J Neuroradiol. 2008;29(5):1006–11.
Warburg O. On the origin of cancer cells. Science. 1956; 123(3191):309–14.
Busch H, Davis JR, Olle EW. Citrate accumulation in slices of transplantable tumors of the rat. Cancer Res. 1957;17(7):711–6.
Vander Heiden M, Cantley L, Thompson C. Understanding the Warburg effect: the metabolic requirements of cell proliferation. Science. 2009;324(5930):1029–33.
Nagasunder AC, Joseph A, Panigrahy A, et al. Prominent citrate predicts malignant progression of low-grade astrocytomas in children. International Society of Magnetic Resonance in Medicine (ISMRM)2010; Stockholm, Sweden.
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Blüml, S. (2013). Diffuse Intrinsic Pontine Gliomas. In: Blüml, S., Panigrahy, A. (eds) MR Spectroscopy of Pediatric Brain Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-5864-8_6
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