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Updated: Jan 1, 2026
A Protocol for Rapid Post-mortem Cell Culture of Diffuse Intrinsic Pontine Glioma DIPG
Published on: March 7, 2017
Diffuse intrinsic pontine gliomas: Diagnostic approach and treatment strategies
M Burhan Janjua1, Vin Shen Ban2, Tarek Y El Ahmadieh2
1Division of Pediatric Neurosurgery, Department of Neurosurgery, UT Southwestern Medical Center, Dallas, TX, United States; Department of Neurosurgery, Shriners Hospital for Children, Philadelphia, PA, United States; Department of Neurosurgery, University of Pennsylvania Hospital, United States.
Abstract:
Diffuse intrinsic pontine gliomas (DIPG) are high grade gliomas of the brainstem with fatal outcomes. Radiation is known to be partially effective to control the immediate flare but relapse is frequent. There has been ongoing research to study the role of molecular subgroups and identification of specific targets but this is not possible with histopathological diagnosis alone. The authors' objective is to highlight the need for and discuss ongoing molecular research. There is an inherent need for the availability of tumor tissue to be able to conduct research studies. The authors advocate the use of neuronavigation assisted stereotactic technique for tumor biopsy. The technique is feasible with a predefined surgical trajectory. After obtaining tissue diagnosis further work can be performed to isolate and identify histone protein genetic mutations and methylation changes responsible for DIPG molecular subgrouping. Moreover, convection enhanced delivery of therapeutic agents is being developed for better instillation of future drug agents. Despite identification of genetic/epigenetic mutations, growth factors, receptors, and tissue biomarkers, the oncogenesis of DIPG remains elusive. The authors' effort to provide a comprehensive review on DIPG to better understand the disease, need for tissue diagnosis, described surgical technique, and need for pre-clinical and clinical future research is novel.
Insights
Diffuse intrinsic pontine gliomas (DIPG) require molecular research beyond histopathology. Neuronavigation-assisted biopsy provides crucial tumor tissue for identifying genetic mutations and developing targeted therapies for this fatal brainstem glioma.
Area of Science:
- Neuro-oncology
- Molecular Pathology
- Surgical Neurology
Background:
- Diffuse intrinsic pontine gliomas (DIPG) are aggressive brainstem tumors with poor prognoses.
- Current treatments, including radiation, offer limited long-term efficacy, with frequent relapses.
- Histopathological diagnosis alone is insufficient for understanding DIPG molecular heterogeneity and identifying therapeutic targets.
Purpose of the Study:
- To emphasize the critical need for molecular research in DIPG.
- To discuss the importance of obtaining tumor tissue for advanced molecular studies.
- To advocate for improved diagnostic and therapeutic strategies for DIPG.
Main Methods:
- Review of current research on DIPG molecular subgroups and therapeutic targets.
- Discussion of neuronavigation-assisted stereotactic biopsy for tumor tissue acquisition.
- Exploration of techniques for identifying histone protein genetic mutations and methylation changes.
- Overview of convection-enhanced delivery (CED) for therapeutic agent instillation.
Main Results:
- Histopathological diagnosis is inadequate for DIPG molecular subtyping.
- Neuronavigation-assisted stereotactic biopsy is a feasible technique for obtaining tumor tissue.
- Molecular analysis can identify genetic/epigenetic mutations and biomarkers.
- Convection-enhanced delivery shows promise for future drug delivery.
Conclusions:
- Acquiring tumor tissue via stereotactic biopsy is essential for advancing DIPG research.
- Molecular profiling is crucial for understanding DIPG oncogenesis and developing targeted therapies.
- Further pre-clinical and clinical research is necessary to overcome the challenges posed by DIPG.
