T2-weighted images are superior to other MR image types for the determination of diffuse intrinsic pontine glioma intratumoral heterogeneity

Harward, Stephen C.; Farber, S. Harrison; Malinzak, Michael; Becher, Oren J.; Thompson, Eric M.

doi:10.1007/s00381-017-3659-8

Cited by 19 publications

(2 citation statements)

References 29 publications

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“…Radiographically, these tumors share common features, such as an enlargement of the native cytoarchitecture (for DIPG, upwards of 50% of the pons), a wispy, non-capsular gadolinium enhancement, and a significant FLAIR signal that often extends beyond the contrast-enhancement pattern ( Figure 2 C,D) [ 24 , 25 ]. Importantly, dichotomizing FLAIR signal into tumor proper and reactive inflammation without obvious tumor cells has been a challenge and the matter of much research aimed at defining better biopsy targets [ 26 , 27 ]. Albeit the subject of much research, this matter is yet to be put to rest: novel imaging modalities are emerging in an effort to answer this question, but to date, biopsy can be the only definitive diagnostic.…”

Section: Symptomatology and Presentationmentioning

confidence: 99%

Diffuse Midline Gliomas: Challenges and New Strategies in a Changing Clinical Landscape

Tosi,

Souweidane

2024

Cancers

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Diffuse intrinsic pontine glioma (DIPG) was first described by Harvey Cushing, the father of modern neurosurgery, a century ago. Since then, the classification of this tumor changed significantly, as it is now part of the broader family of diffuse midline gliomas (DMGs), a heterogeneous group of tumors of midline structures encompassing the entire rostro-caudal space, from the thalamus to the spinal cord. DMGs are characterized by various epigenetic events that lead to chromatin remodeling similarities, as two decades of studies made possible by increased tissue availability showed. This new understanding of tumor (epi)biology is now driving novel clinical trials that rely on targeted agents, with finally real hopes for a change in an otherwise unforgiving prognosis. This biological discovery is being paralleled with equally exciting work in therapeutic drug delivery. Invasive and noninvasive platforms have been central to early phase clinical trials with a promising safety track record and anecdotal benefits in outcome.

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Section: Symptomatology and Presentationmentioning

confidence: 99%

Diffuse Midline Gliomas: Challenges and New Strategies in a Changing Clinical Landscape

Tosi,

Souweidane

2024

Cancers

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“…The average age at diagnosis is 6–9 years old and affected children typically present with a progressive spectrum of neurological deficits. Magnetic resonance imaging most often reveals an expansile, T2-hyperintense, poorly-enhancing mass centered in the pons [ 3 ]. The infiltration of DIPG within the brainstem parenchyma precludes safe surgical resection.…”

Section: Introductionmentioning

confidence: 99%

Diffuse intrinsic pontine glioma cells are vulnerable to low intensity electric fields delivered by intratumoral modulation therapy

Deweyert

Iredale

et al. 2019

J Neurooncol

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Introduction Diffuse intrinsic pontine glioma (DIPG) is a high fatality pediatric brain cancer without effective treatment. The field of electrotherapeutics offers new potential for other forms of glioma but the efficacy of this strategy has not been reported for DIPG. This pilot study evaluated the susceptibility of patient-derived DIPG cells to low intensity electric fields delivered using a developing technology called intratumoral modulation therapy (IMT). Methods DIPG cells from autopsy specimens were treated with a custom-designed, in vitro IMT system. Computer-generated electric field simulation was performed to quantify IMT amplitude and distribution using continuous, low intensity, intermediate frequency stimulation parameters. Treatment groups included sham, IMT, temozolomide (TMZ) chemotherapy and radiation therapy (RT). The impact of single and multi-modality therapy was compared using spectrophotometric and flow cytometry viability analyses. Results DIPG cells exhibited robust, consistent susceptibility to IMT fields that significantly reduced cell viability compared to untreated control levels. The ratio of viable:non-viable DIPG cells transformed from ~ 6:1 in sham-treated to ~ 1.5:1 in IMT-treated conditions. The impact of IMT was similar to that of dual modality TMZ–RT therapy and the addition of IMT to this treatment combination dramatically reduced DIPG cell viability to ~ 20% of control values. Conclusions This proof-of-concept study provides a novel demonstration of marked DIPG cell susceptibility to low intensity electric fields delivered using IMT. The potent impact as a monotherapy and when integrated into multi-modality treatment platforms justifies further investigations into the potential of IMT as a critically needed biomedical innovation for DIPG.

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Pediatric Brain Tumors: Role of Imaging

Tierradentro-García

Sotardi²,

Mankad³

et al. 2022

Evidence-Based Imaging

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T2-weighted images are superior to other MR image types for the determination of diffuse intrinsic pontine glioma intratumoral heterogeneity

Cited by 19 publications

References 29 publications

Diffuse Midline Gliomas: Challenges and New Strategies in a Changing Clinical Landscape

Diffuse Midline Gliomas: Challenges and New Strategies in a Changing Clinical Landscape

Diffuse intrinsic pontine glioma cells are vulnerable to low intensity electric fields delivered by intratumoral modulation therapy

Pediatric Brain Tumors: Role of Imaging

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