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Research ArticlePediatric Neuroimaging
Open Access

Advanced ADC Histogram, Perfusion, and Permeability Metrics Show an Association with Survival and Pseudoprogression in Newly Diagnosed Diffuse Intrinsic Pontine Glioma: A Report from the Pediatric Brain Tumor Consortium

S. Vajapeyam, D. Brown, C. Billups, Z. Patay, G. Vezina, M.S. Shiroishi, M. Law, P. Baxter, A. Onar-Thomas, J.R. Fangusaro, I.J. Dunkel and T.Y. Poussaint
American Journal of Neuroradiology April 2020, DOI: https://doi.org/10.3174/ajnr.A6499
S. Vajapeyam
aFrom the Radiology (S.V., T.Y.P.), Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts
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  • ORCID record for S. Vajapeyam
D. Brown
bDF/HCC Tumor Imaging Metrics Core (D.B.), Massachusetts General Hospital, Boston, Massachusetts
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  • ORCID record for D. Brown
C. Billups
cBiostatistics (C.B., A.O.-T.)
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  • ORCID record for C. Billups
Z. Patay
dDiagnostic Imaging (Z.P.), St. Jude Children’s Research Hospital, Memphis, Tennessee
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G. Vezina
eRadiology (G.V.), Children’s National Medical Center, Washington, DC
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  • ORCID record for G. Vezina
M.S. Shiroishi
fRadiology (M.S.S.), Keck Medical Center of USC, Los Angeles, California
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  • ORCID record for M.S. Shiroishi
M. Law
gNeuroscience (M.L.), Monash University, Melbourne, Australia
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P. Baxter
hCancer and Hematology Center (P.B.), Texas Children’s Hospital, Houston, Texas
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  • ORCID record for P. Baxter
A. Onar-Thomas
cBiostatistics (C.B., A.O.-T.)
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  • ORCID record for A. Onar-Thomas
J.R. Fangusaro
iAflac Cancer and Blood Disorders Center (J.R.F.), Children’s Healthcare of Atlanta, Atlanta, Georgia
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  • ORCID record for J.R. Fangusaro
I.J. Dunkel
jPediatrics (I.J.D.), Memorial Sloan Kettering Cancer Center, New York, New York.
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T.Y. Poussaint
aFrom the Radiology (S.V., T.Y.P.), Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts
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Figures

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    FIG 1.

    Large increase with time in rCBV and mean ve in a 6.6-year-old female short-term survivor (OS = 124 days) with DIPG. Increase in rCBV with time was associated with shorter PFS (P = .004, Q = 0.043) and OS (P < .001, Q < 0.001). An increase in mean ve was marginally associated with shorter PFS (P = .028, Q = 0.104) and OS (P = .030, Q = 0.105).

  • FIG 2.
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    FIG 2.

    Post-RT change in mode_ADC_FLAIR for pseudoprogression cases on the left and true early progression on the right. The striking difference between groups is evident. Note the sharp drop between baseline and post-RT scans in the mode of ADC_FLAIR for true early progression cases on the right compared with the pseudoprogression cases on the left (means, −268.15 versus −26.11; P = .0099). All ADC values are in 10 − 6 mm2/s.

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S. Vajapeyam, D. Brown, C. Billups, Z. Patay, G. Vezina, M.S. Shiroishi, M. Law, P. Baxter, A. Onar-Thomas, J.R. Fangusaro, I.J. Dunkel, T.Y. Poussaint
Advanced ADC Histogram, Perfusion, and Permeability Metrics Show an Association with Survival and Pseudoprogression in Newly Diagnosed Diffuse Intrinsic Pontine Glioma: A Report from the Pediatric Brain Tumor Consortium
American Journal of Neuroradiology Apr 2020, DOI: 10.3174/ajnr.A6499

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Advanced ADC Histogram, Perfusion, and Permeability Metrics Show an Association with Survival and Pseudoprogression in Newly Diagnosed Diffuse Intrinsic Pontine Glioma: A Report from the Pediatric Brain Tumor Consortium
S. Vajapeyam, D. Brown, C. Billups, Z. Patay, G. Vezina, M.S. Shiroishi, M. Law, P. Baxter, A. Onar-Thomas, J.R. Fangusaro, I.J. Dunkel, T.Y. Poussaint
American Journal of Neuroradiology Apr 2020, DOI: 10.3174/ajnr.A6499
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