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Published on: November 11, 2021
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Diffusion Characteristics of Pediatric Diffuse Midline Gliomas with Histone H3-K27M Mutation Using Apparent Diffusion
M S Aboian1, E Tong2, D A Solomon3
1From the Department of Radiology and Biomedical Imaging (M.S.A.), Yale School of Medicine, New Haven, Connecticut mariam.aboian@yale.edu.
AJNR. American Journal of Neuroradiology
|November 8, 2019
Summary
Histone H3 K27M-mutant diffuse midline gliomas show no distinct diffusion characteristics compared to wild-type. However, lower apparent diffusion coefficient (ADC) values correlate with reduced survival rates in these aggressive pediatric brain tumors.
Area of Science:
- Neuro-oncology
- Pediatric neurosurgery
- Medical imaging
Background:
- Diffuse midline gliomas with histone H3 K27M mutation are aggressive tumors with poor prognosis.
- No qualitative imaging differences exist between H3 K27M-mutant and wild-type diffuse midline gliomas.
- Diffusion-weighted imaging (DWI) utility for distinguishing these subtypes is evaluated.
Purpose of the Study:
- To assess the effectiveness of diffusion-weighted imaging in differentiating histone H3 K27M-mutant from wild-type diffuse midline gliomas.
- To explore the correlation between diffusion characteristics and patient survival.
Main Methods:
- 31 pediatric patients with midline gliomas and histone H3 K27M mutation status assessed were included.
- Apparent diffusion coefficient (ADC) was measured using a 3D whole-tumor method.
- ADC histogram parameters were analyzed and compared between mutant and wild-type groups.
Main Results:
- No statistically significant differences in ADC histogram parameters were observed between H3 K27M-mutant and wild-type tumors.
- Subgroup analysis by tumor location did not reveal differences in ADC descriptive statistics.
- Patients with shorter survival (<1 year) exhibited lower median ADC values compared to those surviving longer (>1 year).
Conclusions:
- Diffusion characteristics do not reliably distinguish H3 K27M-mutant from wild-type diffuse midline gliomas.
- Lower ADC values are associated with a poorer 1-year survival rate.
- These findings offer insights into clinical course and outcomes for patients with diffuse midline gliomas.
