PT  - JOURNAL ARTICLE
AU  - Vajapeyam, S.
AU  - Brown, D.
AU  - Ziaei, A.
AU  - Wu, S.
AU  - Vezina, G.
AU  - Stern, J.S.
AU  - Panigrahy, A.
AU  - Patay, Z.
AU  - Tamrazi, B.
AU  - Jones, J.Y.
AU  - Haque, S.S.
AU  - Enterline, D.S.
AU  - Cha, S.
AU  - Jones, B.V.
AU  - Yeom, K.W.
AU  - Onar-Thomas, A.
AU  - Dunkel, I.J.
AU  - Fouladi, M.
AU  - Fangusaro, J.R.
AU  - Poussaint, T.Y.
TI  - ADC Histogram Analysis of Pediatric Low-Grade Glioma Treated with Selumetinib: A Report from the Pediatric Brain Tumor Consortium
AID  - 10.3174/ajnr.A7433
DP  - 2022 Mar 01
TA  - American Journal of Neuroradiology
PG  - 455--461
VI  - 43
IP  - 3
4099  - http://www.ajnr.org/content/43/3/455.short
4100  - http://www.ajnr.org/content/43/3/455.full
SO  - Am. J. Neuroradiol.2022 Mar 01; 43
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