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Conventional MRI cannot predict survival in childhood diffuse intrinsic pontine glioma

  • Clinical-patient studies
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Abstract

Diffuse intrinsic pontine glioma (DIPG) of childhood has a dismal prognosis. Clinical trials of new agents are vital and it is essential that the correct endpoints and disease assessments are chosen. A retrospective review of magnetic resonance imaging (MRI) scanning in a pure population of DIPG was undertaken. Baseline diagnostic MRI findings included; local tumour extension in upper medulla (74%) or midbrain (62%), metastatic disease (3%), basilar artery encasement (82%), necrosis (33%), intratumoural haemorrhage (26%), hydrocephalus (23%) and dorsal exophytic component (18%). Post-treatment MRI scans demonstrated increases in; leptomeningeal metastatic disease (16%), cystic change/necrosis (48%), enhancement (72%) and intratumoural haemorrhage (32%). Response rates were calculated according to both RECIST (4%) and WHO (24%) criteria. No MRI parameter in either the diagnostic or response scans had prognostic significance. We recommend that currently primary endpoints for DIPG clinical trials should be overall or possibly progression free survival and that new advanced functional imaging techniques should be explored as possible surrogate markers for novel therapy activity rather than conventional MRI response criteria.

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Authors and Affiliations

  1. Paediatric Oncology Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, London, SM2 5PT, UK

    Darren Hargrave

  2. San Diego Imaging Medical Group, Rady Children’s Hospital, San Diego, CA, USA

    Nathaniel Chuang

  3. Brain Tumor program, Hospital for Sick Children, Toronto, ON, USA

    Eric Bouffet

Authors
  1. Darren Hargrave
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  2. Nathaniel Chuang
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  3. Eric Bouffet
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Correspondence to Darren Hargrave.

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Hargrave, D., Chuang, N. & Bouffet, E. Conventional MRI cannot predict survival in childhood diffuse intrinsic pontine glioma. J Neurooncol 86, 313–319 (2008). https://doi.org/10.1007/s11060-007-9473-5

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  • DOI: https://doi.org/10.1007/s11060-007-9473-5

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