Skip to main content
Top
Published in: Pediatric Radiology 2/2015

01-02-2015 | Original Article

Diffuse intrinsic pontine glioma: is MRI surveillance improved by region of interest volumetry?

Authors: Garan T. Riley, Paul A. Armitage, Ruth Batty, Paul D. Griffiths, Vicki Lee, John McMullan, Daniel J.A. Connolly

Published in: Pediatric Radiology | Issue 2/2015

Login to get access

Abstract

Background

Paediatric diffuse intrinsic pontine glioma (DIPG) is noteworthy for its fibrillary infiltration through neuroparenchyma and its resultant irregular shape. Conventional volumetry methods aim to approximate such irregular tumours to a regular ellipse, which could be less accurate when assessing treatment response on surveillance MRI. Region-of-interest (ROI) volumetry methods, using manually traced tumour profiles on contiguous imaging slices and subsequent computer-aided calculations, may prove more reliable.

Objective

To evaluate whether the reliability of MRI surveillance of DIPGs can be improved by the use of ROI-based volumetry.

Materials and methods

We investigated the use of ROI- and ellipsoid-based methods of volumetry for paediatric DIPGs in a retrospective review of 22 MRI examinations. We assessed the inter- and intraobserver variability of the two methods when performed by four observers.

Results

ROI- and ellipsoid-based methods strongly correlated for all four observers. The ROI-based volumes showed slightly better agreement both between and within observers than the ellipsoid-based volumes (inter-[intra-]observer agreement 89.8% [92.3%] and 83.1% [88.2%], respectively). Bland-Altman plots show tighter limits of agreement for the ROI-based method.

Conclusion

Both methods are reproducible and transferrable among observers. ROI-based volumetry appears to perform better with greater intra- and interobserver agreement for complex-shaped DIPG.
Literature
1.
go back to reference Freeman CR, Farmer JP (1998) Pediatric brain stem gliomas: a review. Int J Radiat Oncol Biol Phys 40:265–271PubMedCrossRef Freeman CR, Farmer JP (1998) Pediatric brain stem gliomas: a review. Int J Radiat Oncol Biol Phys 40:265–271PubMedCrossRef
2.
go back to reference Donaldson SS, Laningham F, Fisher PG (2006) Advances toward an understanding of brain stem gliomas. J Clin Oncol 24:1266–1272PubMedCrossRef Donaldson SS, Laningham F, Fisher PG (2006) Advances toward an understanding of brain stem gliomas. J Clin Oncol 24:1266–1272PubMedCrossRef
3.
go back to reference Fisher PG, Breiter SN, Carson BS et al (2000) A clinicopathologic reappraisal of brainstem tumor classification: identification of pilocytic astrocytoma and fibrillary astrocytoma as distinct entities. Cancer 89:1569–1576PubMedCrossRef Fisher PG, Breiter SN, Carson BS et al (2000) A clinicopathologic reappraisal of brainstem tumor classification: identification of pilocytic astrocytoma and fibrillary astrocytoma as distinct entities. Cancer 89:1569–1576PubMedCrossRef
5.
go back to reference Eisenhauer EA, Therasse P, Bogaerts J et al (2008) New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). Eur J Cancer 45:228–247CrossRef Eisenhauer EA, Therasse P, Bogaerts J et al (2008) New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). Eur J Cancer 45:228–247CrossRef
6.
go back to reference James K, Eisenhauer EA, Christian M et al (1999) Measuring response in solid tumours: unidimensional versus bidimensional measurement. J Natl Cancer Inst 91:523–528PubMedCrossRef James K, Eisenhauer EA, Christian M et al (1999) Measuring response in solid tumours: unidimensional versus bidimensional measurement. J Natl Cancer Inst 91:523–528PubMedCrossRef
7.
go back to reference Macdonald DR, Cascino TL, Schold SC Jr et al (1990) Response criteria for phase II studies of supratentorial malignant glioma. J Clin Oncol 8:1277–1280PubMed Macdonald DR, Cascino TL, Schold SC Jr et al (1990) Response criteria for phase II studies of supratentorial malignant glioma. J Clin Oncol 8:1277–1280PubMed
8.
go back to reference Schmidt KF, Ziu M, Schmidt NO et al (2004) Volume reconstruction techniques improve the correlation between histological and in vivo tumor volume measurements in mouse models of human gliomas. J Neurooncol 68:207–215PubMedCrossRef Schmidt KF, Ziu M, Schmidt NO et al (2004) Volume reconstruction techniques improve the correlation between histological and in vivo tumor volume measurements in mouse models of human gliomas. J Neurooncol 68:207–215PubMedCrossRef
9.
go back to reference Wapnir IL, Barnard N, Wartenberg D et al (2001) The inverse relationship between microvessel counts and tumor volume in breast cancer. Breast J 7:184–188PubMedCrossRef Wapnir IL, Barnard N, Wartenberg D et al (2001) The inverse relationship between microvessel counts and tumor volume in breast cancer. Breast J 7:184–188PubMedCrossRef
10.
go back to reference Sosna J, Rofsky NM, Gaston SM et al (2003) Determinations of prostate volume at 3-tesla using an external phased array coil comparison to pathologic specimens. Acad Radiol 10:846–853PubMedCrossRef Sosna J, Rofsky NM, Gaston SM et al (2003) Determinations of prostate volume at 3-tesla using an external phased array coil comparison to pathologic specimens. Acad Radiol 10:846–853PubMedCrossRef
11.
go back to reference Mayr NA, Yuh WTC, Taoka T et al (2006) Serial therapy-induced changes in tumor shape in cervical cancer and their impact on assessing tumor volume and treatment response. AJR Am J Roentgenol 187:65–72PubMedCrossRef Mayr NA, Yuh WTC, Taoka T et al (2006) Serial therapy-induced changes in tumor shape in cervical cancer and their impact on assessing tumor volume and treatment response. AJR Am J Roentgenol 187:65–72PubMedCrossRef
12.
go back to reference Keller SS, Roberts N (2009) Measurement of brain volume using MRI: software, techniques, choices and pre-requisites. J Anthropol Sci 87:127–151PubMed Keller SS, Roberts N (2009) Measurement of brain volume using MRI: software, techniques, choices and pre-requisites. J Anthropol Sci 87:127–151PubMed
13.
go back to reference Sawilowsky SS (2005) Misconceptions leading to choosing the t test over the Wilcoxon Mann–Whitney U test for shift in location parameter. J Mod Appl Stat Methods 4:598–600 Sawilowsky SS (2005) Misconceptions leading to choosing the t test over the Wilcoxon Mann–Whitney U test for shift in location parameter. J Mod Appl Stat Methods 4:598–600
14.
go back to reference Frazier JL, Lee J, Thomale UW et al (2009) Treatment of diffuse intrinsic brainstem gliomas: failed approaches and future strategies. J Neurosurg Pediatr 3:259–269PubMedCrossRef Frazier JL, Lee J, Thomale UW et al (2009) Treatment of diffuse intrinsic brainstem gliomas: failed approaches and future strategies. J Neurosurg Pediatr 3:259–269PubMedCrossRef
15.
go back to reference Hargrave D, Bartels U, Bouffet E (2006) Diffuse brainstem glioma in children: critical review of clinical trials. Lancet Oncol 7:241–248PubMedCrossRef Hargrave D, Bartels U, Bouffet E (2006) Diffuse brainstem glioma in children: critical review of clinical trials. Lancet Oncol 7:241–248PubMedCrossRef
16.
go back to reference Wen PY, MacDonald DR, Reardon DA et al (2010) Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol 28:1963–1972PubMedCrossRef Wen PY, MacDonald DR, Reardon DA et al (2010) Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol 28:1963–1972PubMedCrossRef
17.
go back to reference Hayward RM, Patronas N, Baker EH et al (2008) Inter-observer variability in the measurement of diffuse intrinsic pontine gliomas. J Neurooncol 90:57–61PubMedCentralPubMedCrossRef Hayward RM, Patronas N, Baker EH et al (2008) Inter-observer variability in the measurement of diffuse intrinsic pontine gliomas. J Neurooncol 90:57–61PubMedCentralPubMedCrossRef
18.
go back to reference Steffen-Smith EA, Baker EH, Venzon D et al (2014) Measurements of the pons as a biomarker of progression for pediatric DIPG. J Neurooncol 116:127–133PubMedCrossRef Steffen-Smith EA, Baker EH, Venzon D et al (2014) Measurements of the pons as a biomarker of progression for pediatric DIPG. J Neurooncol 116:127–133PubMedCrossRef
Metadata
Title
Diffuse intrinsic pontine glioma: is MRI surveillance improved by region of interest volumetry?
Authors
Garan T. Riley
Paul A. Armitage
Ruth Batty
Paul D. Griffiths
Vicki Lee
John McMullan
Daniel J.A. Connolly
Publication date
01-02-2015
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 2/2015
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-014-3134-6

Other articles of this Issue 2/2015

Pediatric Radiology 2/2015 Go to the issue