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Research ArticlePEDIATRICS

MRI Characteristics of Primary Tumors and Metastatic Lesions in Molecular Subgroups of Pediatric Medulloblastoma: A Single-Center Study

D. Mata-Mbemba, M. Zapotocky, S. Laughlin, M.D. Taylor, V. Ramaswamy and C. Raybaud
American Journal of Neuroradiology March 2018, DOI: https://doi.org/10.3174/ajnr.A5578
D. Mata-Mbemba
aFrom the Department of Diagnostic Imaging (D.M.-M., S.L., C.R.)
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M. Zapotocky
bDivision of Neuro-oncology (M.Z., V.R.)
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S. Laughlin
aFrom the Department of Diagnostic Imaging (D.M.-M., S.L., C.R.)
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M.D. Taylor
cDepartment of Neurosurgery (M.D.T.), Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
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V. Ramaswamy
bDivision of Neuro-oncology (M.Z., V.R.)
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C. Raybaud
aFrom the Department of Diagnostic Imaging (D.M.-M., S.L., C.R.)
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Abstract

BACKGROUND AND PURPOSE: Molecular grouping of medulloblastoma correlates with prognosis and supports the therapeutic strategy. We provide our experience with the imaging features of primary and metastatic disease in relation to the molecular groups.

MATERIALS AND METHODS: One hundred nineteen consecutive patients (mean age, 7.3 ± 3.8 years at diagnosis; male, 79 [66.4%]) with a confirmed diagnosis of medulloblastoma and interpretable pretreatment MRIs were retrieved from our data base from January 2000 to December 2016. Each patient was assigned to wingless, sonic hedgehog, group 3, or group 4 molecular groups. Then, we determined the imaging features of both primary and metastatic/recurrent disease predictive of molecular groups.

RESULTS: In addition to recently reported predictors based on primary tumor, including cerebellar peripheral location for sonic hedgehog (adjusted odds ratio = 9, P < .0001), minimal enhancement of primary group 4 tumor (adjusted odds ratio = 5.2, P < .0001), and cerebellopontine angle location for wingless (adjusted odds ratio = 1.4, P = .03), ependymal metastasis with diffusion restriction and minimal postcontrast enhancement (“mismatching pattern”) (adjusted odds ratio = 2.8, P = .001) for group 4 and spinal metastasis for group 3 (adjusted odds ratio = 1.9, P = .01) also emerged as independent predictors of medulloblastoma molecular groups. Specifically, the presence of a metastasis in the third ventricular infundibular recess showing a mismatching pattern was significantly associated with group 4 (P = .02).

CONCLUSIONS: In addition to imaging features of primary tumors, some imaging patterns of metastatic dissemination in medulloblastoma seem characteristic, perhaps even specific to certain groups. This finding could further help in differentiating molecular groups, specifically groups 3 and 4, when the characteristics of the primary tumor overlap.

ABBREVIATIONS:

aOR
adjusted odds ratio
CPA
cerebellopontine angle
SHH
sonic hedgehog
WNT
wingless

Footnotes

  • Daddy Mata-Mbemba and Michal Zapotocky are co-first authors and contributed equally to this work.

  • Vijay Ramaswamy and Charles Raybaud are co-senior authors and contributed equally to this work.

  • Previously presented, in part, orally at: Annual Meeting of the American Society of Neuroradiology and the Foundation of the ASNR Symposium, April 33–27, 2017; Long Beach, California.

  • © 2018 by American Journal of Neuroradiology
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MRI Characteristics of Primary Tumors and Metastatic Lesions in Molecular Subgroups of Pediatric Medulloblastoma: A Single-Center Study
D. Mata-Mbemba, M. Zapotocky, S. Laughlin, M.D. Taylor, V. Ramaswamy, C. Raybaud
American Journal of Neuroradiology Mar 2018, DOI: 10.3174/ajnr.A5578

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MRI Characteristics of Primary Tumors and Metastatic Lesions in Molecular Subgroups of Pediatric Medulloblastoma: A Single-Center Study
D. Mata-Mbemba, M. Zapotocky, S. Laughlin, M.D. Taylor, V. Ramaswamy, C. Raybaud
American Journal of Neuroradiology Mar 2018, DOI: 10.3174/ajnr.A5578
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