RT Journal Article
SR Electronic
T1 ADC Histogram Analysis of Pediatric Low-Grade Glioma Treated with Selumetinib: A Report from the Pediatric Brain Tumor Consortium
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 455
OP 461
DO 10.3174/ajnr.A7433
VO 43
IS 3
A1 S. Vajapeyam
A1 D. Brown
A1 A. Ziaei
A1 S. Wu
A1 G. Vezina
A1 J.S. Stern
A1 A. Panigrahy
A1 Z. Patay
A1 B. Tamrazi
A1 J.Y. Jones
A1 S.S. Haque
A1 D.S. Enterline
A1 S. Cha
A1 B.V. Jones
A1 K.W. Yeom
A1 A. Onar-Thomas
A1 I.J. Dunkel
A1 M. Fouladi
A1 J.R. Fangusaro
A1 T.Y. Poussaint
YR 2022
UL http://www.ajnr.org/content/43/3/455.abstract
AB 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.MEKMAP (mitogen-activated protein) kinaseNF1neurofibromatosis type 1OPHGoptic pathway and hypothalamic gliomaPBTCPediatric Brain Tumor ConsortiumPFSprogression-free survivalpLGGpediatric low-grade gliomaWHOWorld Health Organization