M W Wagner, L Nobre, K Namdar, F Khalvati, U Tabori, C Hawkins, B B Ertl-Wagner
{"title":"小儿低级别胶质瘤的 T2-FLAIR 错配征象","authors":"M W Wagner, L Nobre, K Namdar, F Khalvati, U Tabori, C Hawkins, B B Ertl-Wagner","doi":"10.3174/ajnr.A7916","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and purpose: </strong>No qualitative imaging feature currently predicts molecular alterations of pediatric low-grade gliomas with high sensitivity or specificity. The T2-FLAIR mismatch sign predicts <i>IDH</i>-mutated 1p19q noncodeleted adult gliomas with high specificity. We aimed to assess the significance of the T2-FLAIR mismatch sign in pediatric low-grade gliomas.</p><p><strong>Materials and methods: </strong>Pretreatment MR images acquired between January 2001 and August 2018 in pediatric patients with pediatric low-grade gliomas were retrospectively identified. Inclusion criteria were the following: 1) 0-18 years of age, 2) availability of molecular information in histopathologically confirmed cases, and 3) availability of preoperative brain MR imaging with non-motion-degraded T2-weighted and FLAIR sequences. Spinal cord tumors were excluded.</p><p><strong>Results: </strong>Three hundred forty-nine patients were included (187 boys; mean age, 8.7 [SD, 4.8] years; range, 0.5-17.7 years). <i>KIAA1549</i>-B-Raf proto-oncogene (<i>BRAF</i>) fusion and <i>BRAF</i> p.V600E mutation were the most common molecular markers (<i>n</i> = 148, 42%, and <i>n</i> = 73, 20.7%, respectively). The T2-FLAIR mismatch sign was present in 25 patients (7.2%). Of these, 9 were dysembryoplastic neuroepithelial tumors; 8, low-grade astrocytomas; 5, diffuse astrocytomas; 1, a pilocytic astrocytoma; 1, a glioneuronal tumor; and 1, an angiocentric glioma. None of the 25 T2-FLAIR mismatch pediatric low-grade gliomas were <i>BRAF</i> p.V600E-mutated. Fourteen of 25 pediatric low-grade gliomas with the T2-FLAIR mismatch sign had rare molecular alterations, while the molecular subtype was unknown for 11 tumors.</p><p><strong>Conclusions: </strong>The T2-FLAIR mismatch sign was not observed in the common molecular alterations, <i>BRAF</i> p.V600E-mutated and <i>KIAA1549-BRAF</i> fused pediatric low-grade gliomas, while it was encountered in pediatric low-grade gliomas with rare pediatric molecular alterations.</p>","PeriodicalId":7875,"journal":{"name":"American Journal of Neuroradiology","volume":"44 7","pages":"841-845"},"PeriodicalIF":3.1000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10337621/pdf/","citationCount":"0","resultStr":"{\"title\":\"T2-FLAIR Mismatch Sign in Pediatric Low-Grade Glioma.\",\"authors\":\"M W Wagner, L Nobre, K Namdar, F Khalvati, U Tabori, C Hawkins, B B Ertl-Wagner\",\"doi\":\"10.3174/ajnr.A7916\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and purpose: </strong>No qualitative imaging feature currently predicts molecular alterations of pediatric low-grade gliomas with high sensitivity or specificity. The T2-FLAIR mismatch sign predicts <i>IDH</i>-mutated 1p19q noncodeleted adult gliomas with high specificity. We aimed to assess the significance of the T2-FLAIR mismatch sign in pediatric low-grade gliomas.</p><p><strong>Materials and methods: </strong>Pretreatment MR images acquired between January 2001 and August 2018 in pediatric patients with pediatric low-grade gliomas were retrospectively identified. Inclusion criteria were the following: 1) 0-18 years of age, 2) availability of molecular information in histopathologically confirmed cases, and 3) availability of preoperative brain MR imaging with non-motion-degraded T2-weighted and FLAIR sequences. Spinal cord tumors were excluded.</p><p><strong>Results: </strong>Three hundred forty-nine patients were included (187 boys; mean age, 8.7 [SD, 4.8] years; range, 0.5-17.7 years). <i>KIAA1549</i>-B-Raf proto-oncogene (<i>BRAF</i>) fusion and <i>BRAF</i> p.V600E mutation were the most common molecular markers (<i>n</i> = 148, 42%, and <i>n</i> = 73, 20.7%, respectively). The T2-FLAIR mismatch sign was present in 25 patients (7.2%). Of these, 9 were dysembryoplastic neuroepithelial tumors; 8, low-grade astrocytomas; 5, diffuse astrocytomas; 1, a pilocytic astrocytoma; 1, a glioneuronal tumor; and 1, an angiocentric glioma. None of the 25 T2-FLAIR mismatch pediatric low-grade gliomas were <i>BRAF</i> p.V600E-mutated. Fourteen of 25 pediatric low-grade gliomas with the T2-FLAIR mismatch sign had rare molecular alterations, while the molecular subtype was unknown for 11 tumors.</p><p><strong>Conclusions: </strong>The T2-FLAIR mismatch sign was not observed in the common molecular alterations, <i>BRAF</i> p.V600E-mutated and <i>KIAA1549-BRAF</i> fused pediatric low-grade gliomas, while it was encountered in pediatric low-grade gliomas with rare pediatric molecular alterations.</p>\",\"PeriodicalId\":7875,\"journal\":{\"name\":\"American Journal of Neuroradiology\",\"volume\":\"44 7\",\"pages\":\"841-845\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10337621/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Neuroradiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3174/ajnr.A7916\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/6/22 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3174/ajnr.A7916","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/6/22 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
T2-FLAIR Mismatch Sign in Pediatric Low-Grade Glioma.
Background and purpose: No qualitative imaging feature currently predicts molecular alterations of pediatric low-grade gliomas with high sensitivity or specificity. The T2-FLAIR mismatch sign predicts IDH-mutated 1p19q noncodeleted adult gliomas with high specificity. We aimed to assess the significance of the T2-FLAIR mismatch sign in pediatric low-grade gliomas.
Materials and methods: Pretreatment MR images acquired between January 2001 and August 2018 in pediatric patients with pediatric low-grade gliomas were retrospectively identified. Inclusion criteria were the following: 1) 0-18 years of age, 2) availability of molecular information in histopathologically confirmed cases, and 3) availability of preoperative brain MR imaging with non-motion-degraded T2-weighted and FLAIR sequences. Spinal cord tumors were excluded.
Results: Three hundred forty-nine patients were included (187 boys; mean age, 8.7 [SD, 4.8] years; range, 0.5-17.7 years). KIAA1549-B-Raf proto-oncogene (BRAF) fusion and BRAF p.V600E mutation were the most common molecular markers (n = 148, 42%, and n = 73, 20.7%, respectively). The T2-FLAIR mismatch sign was present in 25 patients (7.2%). Of these, 9 were dysembryoplastic neuroepithelial tumors; 8, low-grade astrocytomas; 5, diffuse astrocytomas; 1, a pilocytic astrocytoma; 1, a glioneuronal tumor; and 1, an angiocentric glioma. None of the 25 T2-FLAIR mismatch pediatric low-grade gliomas were BRAF p.V600E-mutated. Fourteen of 25 pediatric low-grade gliomas with the T2-FLAIR mismatch sign had rare molecular alterations, while the molecular subtype was unknown for 11 tumors.
Conclusions: The T2-FLAIR mismatch sign was not observed in the common molecular alterations, BRAF p.V600E-mutated and KIAA1549-BRAF fused pediatric low-grade gliomas, while it was encountered in pediatric low-grade gliomas with rare pediatric molecular alterations.
期刊介绍:
The mission of AJNR is to further knowledge in all aspects of neuroimaging, head and neck imaging, and spine imaging for neuroradiologists, radiologists, trainees, scientists, and associated professionals through print and/or electronic publication of quality peer-reviewed articles that lead to the highest standards in patient care, research, and education and to promote discussion of these and other issues through its electronic activities.