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ADC Histogram Analysis of Pediatric Low-Grade Glioma Treated with Selumetinib: A Report from the Pediatric Brain Tumor Consortium

Title: ADC Histogram Analysis of Pediatric Low-Grade Glioma Treated with Selumetinib: A Report from the Pediatric Brain Tumor Consortium
Authors: Vajapeyam, S; Brown, D; Ziaei, A; Wu, S; Vezina, G; Stern, JS; Panigrahy, A; Patay, Z; Tamrazi, B; Jones, JY; Haque, SS; Enterline, DS; Cha, S; Jones, BV; Yeom, KW; Onar-Thomas, A; Dunkel, IJ; Fouladi, M; Fangusaro, JR; Poussaint, TY
Source: American Journal of Neuroradiology, vol 43, iss 3
Publisher Information: eScholarship, University of California
Publication Year: 2022
Collection: University of California: eScholarship
Subject Terms: 32 Biomedical and Clinical Sciences (for-2020); 3202 Clinical Sciences (for-2020); 3211 Oncology and Carcinogenesis (for-2020); Clinical Research (rcdc); Neurosciences (rcdc); Orphan Drug (rcdc); Cancer (rcdc); Pediatric Cancer (rcdc); Pediatric (rcdc); Rare Diseases (rcdc); Brain Disorders (rcdc); Neurofibromatosis (rcdc); Brain Cancer (rcdc); 6.1 Pharmaceuticals (hrcs-rac); Cancer (hrcs-hc); Benzimidazoles (mesh); Brain Neoplasms (mesh); Child (mesh); Diffusion Magnetic Resonance Imaging (mesh); Glioma (mesh); Humans (mesh); Neurofibromatosis 1 (mesh); Proto-Oncogene Proteins B-raf (mesh); 1103 Clinical Sciences (for); 1109 Neurosciences (for); Nuclear Medicine & Medical Imaging (science-metrix); 3209 Neurosciences (for-2020); 3406 Physical chemistry (for-2020)
Subject Geographic: 455 - 461
Description: 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.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: unknown
Relation: qt5xx4n957; https://escholarship.org/uc/item/5xx4n957; https://escholarship.org/content/qt5xx4n957/qt5xx4n957.pdf
DOI: 10.3174/ajnr.a7433
Availability: https://escholarship.org/uc/item/5xx4n957; https://escholarship.org/content/qt5xx4n957/qt5xx4n957.pdf; https://doi.org/10.3174/ajnr.a7433
Rights: public
Accession Number: edsbas.69430DCA
Database: BASE