1. ADC Histogram Analysis of Pediatric Low-Grade Glioma Treated with Selumetinib: A Report from the Pediatric Brain Tumor Consortium
- Author
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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, and Poussaint, TY
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Oncology and Carcinogenesis ,Brain Cancer ,Pediatric ,Cancer ,Brain Disorders ,Rare Diseases ,Pediatric Research Initiative ,Neurosciences ,Benzimidazoles ,Brain Neoplasms ,Child ,Diffusion Magnetic Resonance Imaging ,Glioma ,Humans ,Neurofibromatosis 1 ,Proto-Oncogene Proteins B-raf ,Nuclear Medicine & Medical Imaging ,Clinical sciences ,Physical chemistry - Abstract
Background and purposeSelumetinib 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 methodsChildren 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.ResultsEach 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.ConclusionsADC histogram metrics are associated with progression-free survival and response to treatment with selumetinib in pediatric low-grade gliomas.
- Published
- 2022