Related Experiment Video
Updated: Mar 24, 2026
A Protocol for Rapid Post-mortem Cell Culture of Diffuse Intrinsic Pontine Glioma DIPG
Published on: March 7, 2017
Diffusion tensor imaging suggests extrapontine extension of pediatric diffuse intrinsic pontine gliomas
Matthias W Wagner1, W Robert Bell2, Jason Kern2
1Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
Insights
Diffusion tensor imaging (DTI) can detect early extrapontine extension of pediatric diffuse intrinsic pontine glioma along corticospinal tracts. DTI reveals characteristic changes in white matter integrity, aiding in early diagnosis.
Area of Science:
- Neuroimaging
- Pediatric Oncology
- Diffusion Tensor Imaging
Background:
- Diffuse intrinsic pontine glioma (DIPG) is an aggressive pediatric brain tumor.
- Early detection of extrapontine extension is crucial for treatment planning.
- Conventional MRI may not detect subtle tumor infiltration.
Purpose of the Study:
- To evaluate the utility of DTI in identifying early extrapontine spread of DIPG.
- To assess DTI metrics in the corticospinal tracts of children with DIPG.
- To differentiate DIPG from low-grade brainstem gliomas using DTI.
Main Methods:
- DTI metrics (fractional anisotropy, axial diffusivity, radial diffusivity) were measured in the posterior limb of the internal capsule and posterior centrum semiovale.
- Study included children with DIPG, low-grade brainstem glioma, and age-matched controls.
- Histological confirmation was available in one DIPG patient.
Main Results:
- DIPG patients showed reduced fractional anisotropy and axial diffusivity, and increased radial diffusivity in the corticospinal tracts compared to controls.
- No significant DTI differences were observed between low-grade brainstem glioma and controls.
- Histology confirmed tumor infiltration in the posterior limb of the internal capsule in one DIPG case.
Conclusions:
- DTI-derived changes in white matter integrity suggest early extrapontine tumor extension in DIPG.
- DTI may detect DIPG infiltration along corticospinal tracts earlier than conventional MRI.
- DTI shows promise as a non-invasive tool for assessing DIPG spread.
Purpose:
To apply DTI to detect early extrapontine extension of pediatric diffuse intrinsic pontine glioma along the corticospinal tracts.
Methods:
In children with diffuse intrinsic pontine glioma, low-grade brainstem glioma, and age-matched controls, DTI metrics were measured in the posterior limb of the internal capsule and posterior centrum semiovale. Histological examination was available in one patient.
Results:
6 diffuse intrinsic pontine glioma, 8 low-grade brainstem glioma, and two groups of 25 controls were included. In diffuse intrinsic pontine glioma compared to controls, fractional anisotropy was lower in the bilateral posterior limb of the internal capsule, axial diffusivity was lower in the bilateral posterior centrum semiovale and posterior limb of the internal capsule, while radial diffusivity was higher in the bilateral posterior limb of the internal capsule. No significant differences were found between low-grade brainstem glioma and controls. In diffuse intrinsic pontine glioma compared to low-grade brainstem glioma, axial diffusivity was lower in the bilateral posterior limb of the internal capsule. Histological examination in one child showed tumor cells in the posterior limb of the internal capsule.
Conclusion:
Reduction in fractional anisotropy and axial diffusivity and increase in radial diffusivity in diffuse intrinsic pontine glioma may reflect tumor extension along the corticospinal tracts as shown by histology. DTI may detect early extrapontine tumor extension in diffuse intrinsic pontine glioma before it becomes apparent on conventional MRI sequences.
