Back to Search
Start Over
Imaging features to distinguish posterior fossa ependymoma subgroups.
- Source :
-
European radiology [Eur Radiol] 2024 Mar; Vol. 34 (3), pp. 1534-1544. Date of Electronic Publication: 2023 Sep 02. - Publication Year :
- 2024
-
Abstract
- Objectives: Posterior fossa ependymoma group A (EPN&#95;PFA) and group B (EPN&#95;PFB) can be distinguished by their DNA methylation and give rise to different prognoses. We compared the MRI characteristics of EPN&#95;PFA and EPN&#95;PFB at presentation.<br />Methods: Preoperative imaging of 68 patients with posterior fossa ependymoma from two centers was reviewed by three independent readers, blinded for histomolecular grouping. Location, tumor extension, tumor volume, hydrocephalus, calcifications, tissue component, enhancement or diffusion signal, and histopathological data (cellular density, calcifications, necrosis, mitoses, vascularization, and microvascular proliferation) were compared between the groups. Categorical data were compared between groups using Fisher's exact tests, and quantitative data using Mann-Whitney tests. We performed a Benjamini-Hochberg correction of the p values to account for multiple tests.<br />Results: Fifty-six patients were categorized as EPN&#95;PFA and 12 as EPN&#95;PFB, with median ages of 2 and 20 years, respectively (p = 0.0008). The median EPN&#95;PFA tumoral volume was larger (57 vs 29 cm <superscript>3</superscript> , p = 0.003), with more pronounced hydrocephalus (p = 0.002). EPN&#95;PFA showed an exclusive central position within the 4th ventricle in 61% of patients vs 92% for EPN&#95;PFB (p = 0.01). Intratumor calcifications were found in 93% of EPN&#95;PFA vs 40% of EPN&#95;PFB (p = 0.001). Invasion of the posterior fossa foramina was mostly found for EPN&#95;PFA, particularly the foramina of Luschka (p = 0.0008). EPN&#95;PFA showed whole and homogeneous tumor enhancement in 5% vs 75% of EPN&#95;PFB (p = 0.0008). All mainly cystic tumors were EPN&#95;PFB (p = 0.002). The minimal and maximal relative ADC was slightly lower in EPN&#95;PFA (p = 0.02 and p = 0.01, respectively).<br />Conclusion: Morphological characteristics from imaging differ between posterior fossa ependymoma subtypes and may help to distinguish them preoperatively.<br />Clinical Relevance Statement: This study provides a tool to differentiate between group A and group B ependymomas, which will ultimately allow the therapeutic strategy to be adapted in the early stages of patient management.<br />Key Points: • Posterior fossa ependymoma subtypes often have different imaging characteristics. • Posterior fossa ependymomas group A are commonly median or lateral tissular calcified masses, with incomplete enhancement, affecting young children and responsible for pronounced hydrocephalus and invasion of the posterior fossa foramina. • Posterior fossa ependymomas group B are commonly median non-calcified masses of adolescents and adults, predominantly cystic, and minimally invasive, with total and homogeneous enhancement.<br /> (© 2023. The Author(s), under exclusive licence to European Society of Radiology.)
Details
- Language :
- English
- ISSN :
- 1432-1084
- Volume :
- 34
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- European radiology
- Publication Type :
- Academic Journal
- Accession number :
- 37658900
- Full Text :
- https://doi.org/10.1007/s00330-023-10182-5