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Modeling Brain Metastases Through Intracranial Injection and Magnetic Resonance Imaging
Published on: June 7, 2020
Preferential sites of metastatic relapse on MRI of initially localized ependymoma in children
Mika Shapira Rootman1, Osnat Konen1, Iris Fried2
1Department of Radiology, Schneider Children's Medical Center of Israel, 14 Kaplan Street, PO Box 559, Petach Tikvah 49202, Israel.
Objective:
Relapse of ependymoma in childhood portends a grave prognosis. While the detection of local recurrence is usually simple, spotting leptomeningeal metastasis might be challenging. We aimed to evaluate possible "hotspots" where metastasis tend to appear.
Materials And Methods:
Medical records and Magnetic Resonance (MR) studies of all patients diagnosed with brain ependymomas between the years 2000-2015 were reviewed.
Results:
Leptomeningeal spread was detected among 42% of relapsed patients. The most common sites were spine and hypothalamic area (26% each).
Conclusion:
A meticulous assessment of the brain and spine including a thorough evaluation of the hypothalamic area is recommended.
Insights
Detecting leptomeningeal metastasis in childhood ependymoma is challenging. This study identified the spine and hypothalamic area as common sites for metastasis, aiding early detection in relapsed patients.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Medical Imaging
Background:
- Childhood ependymoma relapse carries a poor prognosis.
- Local recurrence is easily detected, but leptomeningeal metastasis poses diagnostic challenges.
- Identifying common sites of leptomeningeal spread is crucial for timely intervention.
Purpose of the Study:
- To identify frequent locations of leptomeningeal metastasis in pediatric ependymoma.
- To aid in the early detection of ependymoma relapse.
Main Methods:
- Retrospective review of medical records and Magnetic Resonance (MR) studies.
- Analysis of patients diagnosed with brain ependymomas between 2000 and 2015.
Main Results:
- Leptomeningeal spread was observed in 42% of relapsed pediatric ependymoma patients.
- The spine and hypothalamic area were the most frequent sites of metastasis, each occurring in 26% of cases.
Conclusions:
- Meticulous assessment of the brain and spine is recommended for relapsed ependymoma.
- Thorough evaluation of the hypothalamic area is particularly important for detecting leptomeningeal metastasis.
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