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Current concepts in radiologic assessment of pediatric brain tumors during treatment, part 1

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Abstract

Pediatric brain tumors differ from those in adults by location, phenotype and genotype. In addition, they show dissimilar imaging characteristics before and after treatment. While adult brain tumor treatment effects are primarily assessed on MRI by measuring the contrast-enhancing components in addition to abnormalities on T2-weighted and fluid-attenuated inversion recovery images, these methods cannot be simply extrapolated to pediatric central nervous system tumors. A number of researchers have attempted to solve the problem of tumor assessment during treatment in pediatric neuro-oncology; specifically, the Response Assessment in Pediatric Neuro-Oncology (RAPNO) working group was recently established to deal with the distinct challenges in evaluating treatment-related changes on imaging, but no established criteria are available. In this article we review the current methods to evaluate brain tumor therapy and the numerous challenges that remain. In part 1, we examine the role of T2-weighted imaging and fluid-attenuated inversion recovery sequences, contrast enhancement, volumetrics and diffusion imaging techniques. We pay particular attention to several specific pediatric brain tumors, such as optic pathway glioma, diffuse midline glioma and medulloblastoma. Finally, we review the best means to assess leptomeningeal seeding.

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Authors and Affiliations

  1. Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3JH, UK

    Felice D’Arco, Sinead Culleton & Kshitij Mankad

  2. Department of Radiology, AZ Maria Middelares, Ghent, Belgium

    Laurens J. L. De Cocker

  3. Department of Medical Imaging, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada

    Jorge Davila

  4. Department of Radiology, Children’s Hospital Los Angeles, Los Angeles, CA, USA

    Benita Tamrazi

Authors
  1. Felice D’Arco
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  2. Sinead Culleton
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  3. Laurens J. L. De Cocker
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  4. Kshitij Mankad
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  5. Jorge Davila
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Correspondence to Felice D’Arco.

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D’Arco, F., Culleton, S., De Cocker, L.J.L. et al. Current concepts in radiologic assessment of pediatric brain tumors during treatment, part 1. Pediatr Radiol 48, 1833–1843 (2018). https://doi.org/10.1007/s00247-018-4194-9

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  • DOI: https://doi.org/10.1007/s00247-018-4194-9

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