Spurious progression in pediatric brain tumors

Area of Science:

• Pediatric Oncology
• Neuroradiology
• Medical Imaging

Background:

• Post-therapy MRI changes in pediatric brain tumors can mimic disease progression.
• Characterizing these changes is crucial for accurate diagnosis and treatment planning.

Purpose of the Study:

• To characterize "spurious progression" (SP), MRI changes mimicking progression in children with brain tumors.
• To determine if SP is associated with specific tumor types or therapies.

Main Methods:

• Retrospective analysis of 141 pediatric brain tumor patients treated between 2000-2009.
• Inclusion criteria: age <21, ≥3 MRI scans within a year post-therapy.
• SP defined as MRI abnormalities (size, enhancement, edema, cysts) within 12 months post-therapy, followed by stability or improvement.

Main Results:

• 16% of patients exhibited SP; 24% had true progression (TP).
• SP occurred in low-grade (n=20) and high-grade (n=2) tumors.
• Median time to SP was 2.4 months, with resolution by a median of 4 months.

Conclusions:

• Spurious progression is a common finding in pediatric brain tumors, particularly low-grade types.
• SP can occur regardless of therapeutic approach and may require intervention in symptomatic cases.