Related Experiment Video

Updated: Nov 2, 2025

An Aptamer-based Sensor for Unchelated GadoliniumIII
05:15

An Aptamer-based Sensor for Unchelated GadoliniumIII

Published on: January 9, 2017

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Gadolinium is not necessary for surveillance MR imaging in children with chiasmatic-hypothalamic low-grade glioma

Fatema Malbari1, Murali M Chintagumpala2, Alexis C Wood3

  • 1Department of Pediatrics, Division of Neurology and Developmental Neurosciences, Texas Children's Hospital, Houston, Texas.

Pediatric Blood & Cancer
|June 16, 2021
PubMed

Insights

Gadolinium-based contrast agents (GBCA) may not be necessary for monitoring pediatric chiasmatic-hypothalamic low-grade glioma (CHLGG) progression. MRI without GBCA effectively identifies tumor progression, reducing potential gadolinium deposition concerns in children.

Area of Science:

  • Pediatric Neuroradiology
  • Neuro-oncology
  • Medical Imaging

Background:

  • Chiasmatic-hypothalamic low-grade glioma (CHLGG) in children requires frequent MRI monitoring.
  • Concerns exist regarding cumulative gadolinium deposition from contrast agents (GBCA) in pediatric brains.
  • The necessity of GBCA for assessing tumor progression in CHLGG warrants investigation.

Purpose of the Study:

  • To evaluate the necessity of GBCA-enhanced MRI for determining radiographic tumor progression in pediatric CHLGG.
  • To assess the diagnostic yield of non-contrast MRI sequences in identifying disease progression.

Main Methods:

  • Retrospective review of 28 pediatric CHLGG patients treated between 2005-2019.
  • Independent blinded review of pre- and post-contrast MRI sequences by a neuroradiologist.
  • Tumor size and characteristics evaluated; progression defined as a 25% increase in size.

Main Results:

  • 99% of radiographic progressions were identified on non-contrast MRI, compared to 98% on contrast-enhanced MRI.
  • 100% of progressions requiring management changes were detected on non-contrast sequences.
  • Non-contrast imaging identified tumor growth >2mm in 98% of cases, similar to contrast-enhanced scans.

Conclusions:

  • MRI without GBCA is effective in identifying disease progression in pediatric CHLGG.
  • Eliminating GBCA during routine MRI monitoring for CHLGG should be considered.
  • GBCA may still be necessary for monitoring patients with metastatic disease.
Abstract

Keywords:
gadoliniumhypothalamic-chiasmaticlow-grade gliomapediatricsurveillance imaging

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