Tumour vasculature and angiogenic profile of paediatric pilocytic astrocytoma; is it much different from glioblastoma?

Sie, Mariska; Bont, de Eveline; Scherpen, Frank J.G.; Hoving, Eelco W.; Dunnen, den Wilfred

doi:10.1111/j.1365-2990.2010.01113.x

Cited by 45 publications

(39 citation statements)

References 54 publications

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“…All 5 cases of pilocytic astrocytomas included in our study had very high rCBV values which were more than the cutoff value of 2.41 used for discriminating low-grade lesions from high-grade ones. These results are in line with the immunohistochemistry and mean vessel density observations in these neoplasms [21,20] .…”

Section: Discussionsupporting

confidence: 80%

“…Different MR-based perfusion methods may yield variable results and are not directly comparable [26] . Even though we had a small number of pilocytic astrocytoma patients in our study, our results are in line with the histological observation of an increased vessel density and the presence of significant angiogenesis in these tumors [20] .…”

Section: Discussionsupporting

confidence: 76%

“…Perfusion imaging has been used extensively to study this biological process and to understand the tumor biology, grade tumors, and assess the treatment response. However, angiogenesis is not limited to high-grade gliomas as it has been noted that pilocytic astrocytomas show a significant overlap with high-grade gliomas in terms of the presence of immature vessels as well as the angiogenic profile, although a different vascular morphology is seen in these tumors [20] . All of the pilocytic astrocytomas in our study were found to have very high rCBV values and they were indistinguishable from other high-grade tumors like ependymomas.…”

Section: Discussionmentioning

confidence: 99%

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Role of Dynamic Contrast-Enhanced Perfusion Magnetic Resonance Imaging in Grading of Pediatric Brain Tumors on 3T

Gupta¹,

Saini²,

Sahoo³

et al. 2017

Pediatr Neurosurg

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Background/Aims: Perfusion magnetic resonance imaging (MRI) is useful for preoperative assessment of brain tumors. Dynamic susceptibility contrast perfusion MRI is commonly used for evaluation of brain tumors. Dynamic contrast-enhanced (DCE) MRI is an alternative method that has mainly been used in adult brain tumors. In this preliminary study, we report our initial experience with the DCE perfusion MRI in pediatric brain tumors. Methods: Sixty-four newly diagnosed pediatric brain tumor patients underwent DCE perfusion MRI on a 3-T scanner. Hemodynamic and kinetic parametric maps were generated and the regions with the highest values were measured on each map. Statistical differences were sought to differentiate between low-grade tumors, high-grade tumors, and medulloblastomas. The perfusion metrics of common posterior fossa tumors were also compared. Results: Relative corrected cerebral blood volume (rCBV) and fractional plasma volume measures differed significantly between high- and low-grade tumors (p < 0.05). High-grade tumors could be differentiated from low-grade tumors, with an rCBV cutoff value of 2.41 and 88.6% sensitivity and 65% specificity. There was no significant difference in K^trans, K_ep, V_e, or λ^tr between these 2 groups of tumors. rCBV, relative quantification of the cerebral blood flow, and permeability indices were found to be significantly different in various posterior fossa tumors, i.e., pilocytic astrocytoma, ependymoma, and medulloblastoma (p < 0.05). Conclusion: DCE-derived perfusion metrics are useful in differentiating high-grade tumors from low-grade ones and discriminating among various posterior fossa tumors in the pediatric age group.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

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Role of Dynamic Contrast-Enhanced Perfusion Magnetic Resonance Imaging in Grading of Pediatric Brain Tumors on 3T

Gupta¹,

Saini²,

Sahoo³

et al. 2017

Pediatr Neurosurg

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“…This finding may be attributed to the characteristic capillary exchange rate within the pilocytic tumor tissues, vessel density, and micro- vascular architecture or integrity. 41,42 Although not statistically different, OPG consistently showed slightly lower perfusion than other pilocytic astrocytomas. Given reports of increased microvessel density in OPG with more aggressive behavior, 43 exclusion of OPG that required therapy could have biased toward a subset of less vascular, or biologically less aggressive, OPG in our cohort.…”

Section: Discussionmentioning

confidence: 99%

Arterial Spin-Labeled Perfusion of Pediatric Brain Tumors

Yeom¹,

Mitchell²,

Lober³

et al. 2013

American Journal of Neuroradiology

110

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BACKGROUND AND PURPOSE: Pediatric brain tumors have diverse pathologic features, which poses diagnostic challenges. Although perfusion evaluation of adult tumors is well established, hemodynamic properties are not well characterized in children. Our goal was to apply arterial spin-labeling perfusion for various pathologic types of pediatric brain tumors and evaluate the role of arterial spin-labeling in the prediction of tumor grade.

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“…A key promoter in angiogenesis is the upregulated expression of VEGF in response to regional tissue hypoxia as mediated by hypoxia-inducible factor-1. In a comparative immunohistochemical morphometric analysis of the vasculature in PAs versus that in glioblastomas, Sie et al 20 noted an overlapping increased expression of VEGF in both types of glioma. However, in the PA group the level of this expression inversely correlated with the density of the microvasculature, implicating the role of local tissue hypoxia as the agent for upregulation.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic presentations of cerebellar pilocytic astrocytomas in children resulting in death: report of 2 cases

Wilson

Johnson²,

Hawkins

et al. 2016

PED

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Acute hemorrhagic presentation in pilocytic astrocytomas (PAs) has become increasingly recognized. This type of presentation poses a clinically emergent situation in those hemorrhages arising in PAs of the cerebellum, the most frequent site, because of the limited capacity of the posterior fossa to compensate for mass effect, predisposing to rapid neurological deterioration. As examples, we describe two cases of fatal hemorrhagic cerebellar PAs: one of a child with a slowly growing stereotypical WHO Grade I PA with a 1-year period of symptomatology that preceded a rapid clinical deterioration, and another of an asymptomatic child having a PA variant, presenting with progressive obtundation following a presumed Valsalva event. These two scenarios parallel previous reports in the literature of either a setting of progressive expression of cerebellar dysfunction and transient episodes of raised intracranial pressure (ICP), or abrupt onset of features of increased ICP in a previously well child. The literature is further reviewed for a current understanding of the factors that predispose, initiate and propagate bleeding, with specific reference to the role of vascular endothelial growth factor and other angiogenic agents in the genesis and stability of the vasculature in PAs. In this context, we propose that obliterative vascular mural hyalinization with associated altered flow dynamics and microaneurysm formation was the pathogenesis of the hemorrhage in our first case. In the second case, large tumor size, increased growth rate, looseness of the background myxoid matrix, and thinness of the tumor blood vessels with calcospherite deposition predisposed to vascular leakage and bleeding concurrent with sudden increases in intravascular hydrostatic pressure. In that cerebellar PAs are common, this report underscores the importance of considering in the differential diagnosis the possibility of a spontaneous hemorrhage in a posterior fossa PA in a child presenting with a sudden neurological ictus and raised ICP.

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Tumour vasculature and angiogenic profile of paediatric pilocytic astrocytoma; is it much different from glioblastoma?

Cited by 45 publications

References 54 publications

Role of Dynamic Contrast-Enhanced Perfusion Magnetic Resonance Imaging in Grading of Pediatric Brain Tumors on 3T

Role of Dynamic Contrast-Enhanced Perfusion Magnetic Resonance Imaging in Grading of Pediatric Brain Tumors on 3T

Arterial Spin-Labeled Perfusion of Pediatric Brain Tumors

Hemorrhagic presentations of cerebellar pilocytic astrocytomas in children resulting in death: report of 2 cases

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