Article Figures & Data
Figures
- Fig 1.
Axial MR images centered on the pons and showing non-necrotic T2HrF (long arrow). T2-weighted image (A), ADC map (B), T1-weighted postcontrast subtraction image (C), and CBV map (D). These images show a well-defined, fairly voluminous T2HrF within the left hemipons (a smaller similar lesion may be present on the right side, too), which is associated with mass effect, slightly increased signal in ADC (B), lack of contrast enhancement after IV gadolinium injection (C), and moderately increased CBV (D).
- Fig 2.
Axial (A) and sagittal (B) T2-weighted MR images of a DIPG with both non-necrotic T2HrF (arrowhead) and T2HoF (long arrow).
- Fig 3.
Boxplots of ADC, rCBV, Ktrans, and ve for the different ROI types analyzed in DIPG. The y-axis of boxplots was rescaled for rCBV, Ktrans, and ve. Error bars represent SDs. Statistical differences between groups (P < .05) are signified as follows: The asterisk indicates normal brain stem, ¥, T2HoF; ‡, necrotic T2HrF; §, edema.
- Fig 4.
Feature comparison of the 4 ROIs. A, Normal brain stem. B, A non-necrotic T2HrF is a well-circumscribed intratumoral area exhibiting high T2 signal and is often associated with local mass effect on surrounding structures, shown by splaying transverse pontocerebellar fibers. C, T2HoF are characterized by low T2 signal and are locally expansile. D, Necrotic T2HrF exhibit irregular margins, central T2 hypersignal, peripheral T2 hyposignal, and postcontrast signal enhancement. On the basis of their advanced MR imaging features, we speculate that non-necrotic T2HrF, T2HoF, and necrotic T2HrF, while possibly coexisting, may indicate sequential steps in the evolution of tumor cell populations (clones).
Tables
Measurement of advanced MRI-based surrogate biomarkers in 5 regionsa
Region ADC (×10−3 mm2/s) rCBV Ktrans (min−1) ve Normal brain stem (n = 17) 0.75 ± 0.04 1.36 ± 0.21 NA NA Peritumoral edema (n = 22) 1.42 ± 0.27b 1.04 ± 0.31b 0.0028 ± 0.0020 0.0035 ± 0.0030 Non-necrotic T2HrF (n = 16) 1.48 ± 0.41b,c 1.38 ± 0.68c,d 0.0034 ± 0.0025c,d 0.0057 ± 0.0042 T2HoF (n = 13) 0.82 ± 0.16d,e 3.82 ± 1.32b,e 0.0112 ± 0.0071e 0.0163 ± 0.0184e Necrotic T2HrF (n = 9) 1.47 ± 0.23b 3.61 ± 1.63b,e 0.0108 ± 0.0072e 0.0171 ± 0.0132e
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