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Published in: Child's Nervous System 5/2014

01-05-2014 | Original Paper

Preliminary experience with diffusion tensor imaging before and after re-irradiation treatments in children with progressive diffuse pontine glioma

Authors: Soumen Khatua, Ping Hou, Ravi Bodiwala, Johannes Wolff, Jackson Hamilton, Shekhar Patil, Wafik Zaky, Anita Mahajan, Leena Ketonen

Published in: Child's Nervous System | Issue 5/2014

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Abstract

Purpose

The purpose of this study is to evaluate quantitative changes in diffusion tensor imaging (DTI) tractography and fractional anisotropy (FA) of the pons along with clinical correlation, in patients who receive re-irradiation for progressive diffuse intrinsic pontine glioma (DIPG).

Methods

A retrospective case review of children with progressive DIPG who received re-irradiation at our institution from 2007 to 2011 after approval from the Institutional Review Board was performed. Tractography analysis and FA were analyzed pre and post-re-irradiation, and correlation with clinical features and MR imaging was performed.

Results

DTI analysis showed reduced values of FA on tumor progression. Increase in the FA values was noted after re-irradiation in these patients. This correlated with clinical improvement. These changes were concordant with the 3D tractography analysis which showed better visualization of the corticospinal tracts as they course through brainstem and posterior transverse pontine fibers following re-irradiation.

Conclusion

Serial changes in the FA values using DTI could provide clinically more correlative information in patients with progressive DIPG, who receive re-irradiation. Though the use and results of this modality has been reported in the newly diagnosed DIPG before, evaluation of DTI in children who receive re-irradiation for progressive DIPG has not been reported earlier. Though limited by the small sample size and treatment variability, this study for the first time shows the preliminary experience, potential, and likely efficacy of complementing DTI analysis to routine neuroimaging also in patients re-irradiated for progressive DIPG to better assess treatment response.
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Metadata
Title
Preliminary experience with diffusion tensor imaging before and after re-irradiation treatments in children with progressive diffuse pontine glioma
Authors
Soumen Khatua
Ping Hou
Ravi Bodiwala
Johannes Wolff
Jackson Hamilton
Shekhar Patil
Wafik Zaky
Anita Mahajan
Leena Ketonen
Publication date
01-05-2014
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 5/2014
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-013-2350-y

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