Related Experiment Video
Updated: Apr 15, 2026
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
The effect of chemotherapy on optic pathway gliomas and their sub-components: A volumetric MR analysis study
Ben Shofty1,2, Michal Mauda-Havakuk1,3, Lior Weizman4
1The Gilbert Israeli Neurofibromatosis Center.
Background:
Optic pathway gliomas (OPG) represent 5% of pediatric brain tumors and compose a major therapeutic dilemma to the treating physicians. While chemotherapy is widely used for these tumors, our ability to predict radiological response is still lacking. In this study, we use volumetric imaging to examine in detail the long-term effect of chemotherapy on the tumor as well as its various sub-components.
Procedure:
The tumors of 15 patients with OPG, treated with chemotherapy, were longitudinally measured using our novel, previously described volumetric method. Patients were treated with up to five lines of chemotherapy. Sufficient follow-up imaging data, and patient's numbers, allowed for analysis of two treatment lines. Volumetric measurements of the tumors were segmented into solid-non-enhancing, solid-enhancing, and cystic components. Outcome analysis was done per specific treatment line and for the overall follow-up period.
Results:
An average reduction of 9.7% (±23%) in the gross-total-solid volume (GTSV) was noted following treatment with vincristine and carboplatin. The cystic component grew under therapy by an average of 12.6% (±39%). When measured over the course of the whole study period, the cystic component grew by an average of 35% (±100%) and the GTSV increased by 12% (±35%).
Conclusion:
Initial treatment with vincristine and carboplatin seems to have a minimal initial effect, mostly on the solid components. The cystic component in itself seems to be unaffected by chemotherapy, and contributes to the subsequent growth of the total volume. During the overall treatment period, both solid and cystic components grew regardless of combined treatment methods.
Insights
Chemotherapy shows minimal initial effect on pediatric optic pathway gliomas (OPG), with cystic components growing during treatment. Long-term analysis reveals overall tumor growth despite various chemotherapy regimens.
Area of Science:
- Pediatric neuro-oncology
- Neuroimaging
- Chemotherapy response assessment
Background:
- Optic pathway gliomas (OPG) are common pediatric brain tumors with challenging treatment responses to chemotherapy.
- Predicting radiological response in OPG remains difficult, necessitating detailed volumetric analysis.
Purpose of the Study:
- To investigate the long-term volumetric effects of chemotherapy on OPG and their sub-components.
- To assess the efficacy of chemotherapy in reducing tumor volume and analyze the behavior of solid and cystic components.
Main Methods:
- Longitudinal volumetric measurements of OPG in 15 pediatric patients using a novel method.
- Segmentation of tumors into solid-non-enhancing, solid-enhancing, and cystic components.
- Analysis of treatment response after specific chemotherapy lines and over the entire follow-up period.
Main Results:
- Vincristine and carboplatin showed a minor average reduction of 9.7% in gross-total-solid volume (GTSV).
- The cystic component demonstrated an average growth of 12.6% during therapy and 35% over the study period.
- GTSV increased by 12% over the entire study period, indicating overall tumor growth.
Conclusions:
- Initial chemotherapy (vincristine and carboplatin) has limited impact, primarily on solid tumor components.
- Chemotherapy does not significantly affect the cystic component, which contributes to tumor progression.
- Both solid and cystic components of OPG exhibit growth over the long-term treatment period, irrespective of the chemotherapy regimen used.
