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Neuroradiology
Published in: Neuroradiology 1/2020

01-01-2020 | Astrocytoma | Paediatric Neuroradiology

Role of diffusion weighted imaging for differentiating cerebral pilocytic astrocytoma and ganglioglioma BRAF V600E-mutant from wild type

Authors: Antonia Ramaglia, Domenico Tortora, Kshitij Mankad, Maarten Lequin, Mariasavina Severino, Felice D’Arco, Ulrike Löbel, Massimo Benenati, Wendy W. J. de Leng, Patrizia De Marco, Claudia Milanaccio, Andrea Rossi, Giovanni Morana

Published in: Neuroradiology | Issue 1/2020

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Abstract

Purpose

BRAF V600E mutation is a distinctive genomic alteration of pediatric low-grade gliomas with prognostic and therapeutic implications. The aim of this retrospective multicenter study was to analyze imaging features of BRAF V600E-mutant and wild-type cerebral pilocytic astrocytomas (PAs) and gangliogliomas (GGs), focusing on the role of diffusion weighted imaging (DWI).

Methods

We retrospectively evaluated 56 pediatric patients with histologically proven, treatment-naïve PAs and GGs who underwent conventional MRI, DWI, and molecular analysis for BRAF V600E mutation. Twenty-three subjects presented BRAF V600E-mutant (12 PAs and 11 GGs) and 33 BRAF V600E wild-type (26 PAs and 7 GGs) tumors. Imaging studies were reviewed for dominant site, margin definition, hemorrhage, calcification, cystic components, contrast enhancement, and relative mean and minimum ADC values (rADCmean and rADCmin). Statistics included Fisher’s exact test, Student t test, general linear model, and receiver operating characteristic (ROC) analysis.

Results

PA and GG BRAF V600E-mutant had significantly lower rADCmean (p < 0.001) and rADCmin (p < 0.001) values than wild type, regardless of tumor histology and location. ROC analysis demonstrated similar performances between these parameters in predicting BRAF V600E status (rADCmean: AUC 0.831, p < 0.001; rADCmin: AUC 0.885, p < 0.001).
No significant differences regarding additional imaging features emerged between BRAF V600E-mutant and wild-type lesions, with the exception of the number of tumors with cystic components, significantly higher in BRAF V600E-mutant PAs (p = 0.011)

Conclusion

Assessment of the DWI characteristics of GGs and PAs may assist in predicting BRAF V600E status, suggesting a radiogenomic correlation and prompt molecular characterization of these tumors.
Appendix
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Metadata
Title
Role of diffusion weighted imaging for differentiating cerebral pilocytic astrocytoma and ganglioglioma BRAF V600E-mutant from wild type
Authors
Antonia Ramaglia
Domenico Tortora
Kshitij Mankad
Maarten Lequin
Mariasavina Severino
Felice D’Arco
Ulrike Löbel
Massimo Benenati
Wendy W. J. de Leng
Patrizia De Marco
Claudia Milanaccio
Andrea Rossi
Giovanni Morana
Publication date
01-01-2020
Publisher
Springer Berlin Heidelberg
Published in
Neuroradiology / Issue 1/2020
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-019-02304-y

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