Recurrence patterns in pediatric intracranial ependymal neoplasm: a systematic imaging work-up.

IF 2.4 3区医学 Q2 CLINICAL NEUROLOGY

Neuroradiology Pub Date : 2025-02-17 DOI:10.1007/s00234-025-03553-w

Annika Stock, Judith Krumma, Gudrun Fleischhack, Stephan Tippelt, Lydia Rink, Torsten Pietsch, Martin Mynarek, Denise Obrecht-Sturm, Stefan Rutkowski, Stefan M Pfister, Dominik Sturm, Kristian W Pajtler, Ulrich Schüller, Beate Timmermann, Rolf-Dieter Kortmann, Brigitte Bison, Mirko Pham, Monika Warmuth-Metz

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引用次数: 0

Abstract

Purpose: Currently, the different types of ependymal neoplasm (EPN) are defined by anatomical localization and genetics. This retrospective multicenter study aimed to analyze the imaging patterns of both local and distant recurrences in supratentorial (ST) and posterior fossa (PF) EPN.

Methods: We exclusively evaluated patients with recurrent EPN. To form the basis for follow-up evaluations the imaging characteristics for ST-EPN and PF-EPN were assessed and compared to each other. Follow-up assessments included the idenTIFFication of local recurrent tumors, leptomeningeal dissemination, secondary intraparenchymal lesions, and extraneural metastases. MR-signal characteristics of local recurrent tumors were compared to the primary tumor.

Results: The imaging series included 73 patients (median age at diagnosis 4.6 years; 56 PF-EPN). Recurrences were observed at up to five time points, with a total of 145 recurrence events documented. At first recurrence most PF-EPN recurred locally (29/56), while ST-EPN relapsed by intracranial dissemination (9/17). Local recurrent tumor grew fast and differed in up to one-fifth from the primary (13.2% lower T2-signal, 14.6% brighter T1-signal, 19% less contrast-enhancement). Leptomeningeal dissemination in ST-EPN is mainly restricted to intracranial (90.5%) while PF-EPN more frequently present with spinal spread (45.7%). Transient post-radiogenic lesions (n = 2) and secondary malignancies (n = 2) were rare. Extraneural metastases (n = 3) were found mainly near the surgical access.

Conclusion: Recurrences can occur multiple times in EPN patients, and the recurrence patterns differ between ST-EPN and PF-EPN. Imaging characteristics of local recurrences can differ from the primary tumor which is crucial for accurate diagnosis and treatment planning.

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.