ADC histogram analysis of pediatric low-grade glioma treated with selumetinib: A report from the Pediatric Brain Tumor Consortium Journal Article
| Authors: | Vajapeyam, S.; Brown, D.; Ziaei, A.; Wu, S.; Vezina, G.; Stern, J. S.; Panigrahy, A.; Patay, Z.; Tamrazi, B.; Jones, J. Y.; Haque, S. S.; Enterline, D. S.; Cha, S.; Jones, B. V.; Yeom, K. W.; Onar-Thomas, A.; Dunkel, I. J.; Fouladi, M.; Fangusaro, J. R.; Poussaint, T. Y. |
| Article Title: | ADC histogram analysis of pediatric low-grade glioma treated with selumetinib: A report from the Pediatric Brain Tumor Consortium |
| Abstract: | BACKGROUND AND PURPOSE: Selumetinib is a promising MAP (mitogen-activated protein) kinase (MEK) 1/2 inhibitor treatment for pediatric low-grade gliomas. We hypothesized that MR imaging–derived ADC histogram metrics would be associated with survival and response to treatment with selumetinib. MATERIALS AND METHODS: Children with recurrent, refractory, or progressive pediatric low-grade gliomas who had World Health Organization grade I pilocytic astrocytoma with KIAA1549–BRAF fusion or the BRAF V600E mutation (stratum 1), neurofibromatosis type 1–associated pediatric low-grade gliomas (stratum 3), or sporadic non-neurofibromatosis type 1 optic pathway and hypothalamic glioma (OPHG) (stratum 4) were treated with selumetinib for up to 2 years. Quantitative ADC histogram metrics were analyzed for total and enhancing tumor volumes at baseline and during treatment. RESULTS: Each stratum comprised 25 patients. Stratum 1 responders showed lower values of SD of baseline ADC_total as well as a larger decrease with time on treatment in ADC_total mean, mode, and median compared with nonresponders. Stratum 3 responders showed a greater longitudinal decrease in ADC_total. In stratum 4, higher baseline ADC_total skewness and kurtosis were associated with shorter progression-free survival. When all 3 strata were combined, responders showed a greater decrease with time in ADC_total mode and median. Compared with sporadic OPHG, neurofibromatosis type 1–associated OPHG had lower values of ADC_total mean, mode, and median as well as ADC_enhancement mean and median and higher values of ADC_total skewness and kurtosis at baseline. The longitudinal decrease in ADC_total median during treatment was significantly greater in sporadic OPHG compared with neurofibromatosis type 1–associated OPHG. CONCLUSIONS: ADC histogram metrics are associated with progression-free survival and response to treatment with selumetinib in pediatric low-grade gliomas. Copyright 2022 by American Society of Neuroradiology. |
| Journal Title: | American Journal of Neuroradiology |
| Volume: | 43 |
| Issue: | 3 |
| ISSN: | 0195-6108 |
| Publisher: | American Society of Neuroradiology |
| Date Published: | 2022-03-01 |
| Start Page: | 455 |
| End Page: | 461 |
| Language: | English |
| DOI: | 10.3174/ajnr.A7433 |
| PUBMED: | 35210278 |
| PROVIDER: | scopus |
| PMCID: | PMC8910799 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 April 2022 -- Source: Scopus |
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