scholarly journals SEIZURES IN CHILDREN WITH LOW GRADE GLIOMA

2021 ◽  
Vol 7 (1) ◽  
pp. 60-65
Author(s):  
Piyush Ostwal ◽  
Shanbhag Nandan
Keyword(s):  
Brain Tumors ◽  
Pediatric Brain Tumors ◽  
Dysembryoplastic Neuroepithelial Tumor ◽  
Histopathological Diagnosis ◽  
Low Grade ◽  
Tumor Type ◽  
Low Grade Gliomas ◽  
Primary Treatment Modality ◽  
Antiepileptic Medications ◽  
Pediatric Brain

Seizures are a common presentation of pediatric brain tumors. The incidence of pediatric brain tumor (Age 0-19 years) ranges from 1.12–5.26 cases per 100,000 persons. Low grade gliomas are an important subgroup of pediatric brain tumors causing epilepsy. Low-grade gliomas are largely slow-growing tumors and the manifestations are dependent on age, location, tumor type, size of tumor and rate of tumor growth. Seizures have been reported in up to 38 % of children with supratentorial tumors. The tumors are identified when work up of patients for epilepsy includes electrophysiological and imaging studies. The primary treatment modality remains surgical excision. Antiepileptic medications are used for control of seizures. Subsequent histopathological diagnosis is important for prognostication. The tumors commonly associated with long-term epilepsy in various studies were ganglioglioma, dysembryoplastic neuroepithelial tumor, pilocytic astrocytoma and pilocytic xanthoastrocytoma. The outcome of surgery with regards to seizure control is generally good. Though concomitantly antiepileptic medications will be needed for most of them. An attempt is made in this review to summarize the epidemiology, clinical features, pathology and treatment aspects of pediatric low grade gliomas presenting with seizures.

scholarly journals Detection of human herpesvirus-6 variants in pediatric brain tumors: Association of viral antigen in low grade gliomas

2009 ◽  
Vol 46 (1) ◽  
pp. 37-42 ◽  
Author(s):  
John R. Crawford ◽  
Maria R. Santi ◽  
Halldora K. Thorarinsdottir ◽  
Robert Cornelison ◽  
Elisabeth J. Rushing ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Viral Antigen ◽  
Human Herpesvirus ◽  
Pediatric Brain Tumors ◽  
Low Grade ◽  
Human Herpesvirus 6 ◽  
Low Grade Gliomas ◽  
Herpesvirus 6 ◽  
Pediatric Brain

scholarly journals PATH-20. METHYLATION ARRAY PROFILING OF PEDIATRIC BRAIN TUMORS; SINGLE CENTRE EXPERIENCE

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii428-iii428
Author(s):  
Michal Zapotocky ◽  
Ales Vicha ◽  
Lenka Krskova ◽  
Josef Zamecnik ◽  
Lucie Stolova ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Molecular Diagnosis ◽  
Pediatric Brain Tumors ◽  
Histological Diagnosis ◽  
Diagnostic Process ◽  
Low Grade ◽  
Significant Heterogeneity ◽  
Tumor Type ◽  
Methylation Array ◽  
Pediatric Brain

Abstract BACKGROUND Significant heterogeneity of pediatric brain tumors poses major challenge on diagnostics. Therefore, we aimed to evaluate feasibility of methylation array in the diagnostic process. METHODS Methylation array (Infinium MethylationEPIC, Illumina) was performed on DNA extracted from fresh frozen tissue from prospective newly diagnosed and selected retrospective patients. Results from Heidelberg classifier (www.molecularneuropathology.org) were compared to the histological diagnosis and further genetic testing was performed to establish integrated morphological/molecular diagnosis. RESULTS Within years 2018–2019, we performed methylation array profiling of 102 samples consisting mainly of ependymoma, medulloblastoma high-grade and low-grade glioma. High calibrated score (>0.9) was achieved in 62 patients (61%). In 46 cases (74%) with score >0.9, the histological diagnosis matched the methylation class (MC). In the remaining cases (16) that were classified by histopathology mainly as ependymomas, the methylation profiles were classified as novel molecular entities (HGNET_BCOR, HGNET_MN1, etc.) or different tumor type. In 40 cases (39%) with the score <0.9, six were found to have high normal tissue content. Nine cases had no match in the classifier and 25 were assigned MC with score 0.3 to 0.89. In 20 out of 34 cases with low score, the molecular diagnosis could be confirmed based on copy number variants inferred from the methylation array or using additional testing for gene fusions and mutations. CONCLUSIONS Our experience on the first 100+ cases demonstrated that methylation array could be integral part of diagnostic process in order to establish integrated morphological and molecular diagnosis of pediatric brain tumors.

Delayed cognitive, behavioral, and radiological changes related to canial irradiation for pediatric brain tumors

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 20023-20023
Author(s):  
M. M. Abdel Wahab ◽  
H. Hussien ◽  
K. M. Maher
Keyword(s):  
White Matter ◽  
Brain Tumors ◽  
Visual Memory ◽  
Statistical Significance ◽  
Pediatric Brain Tumors ◽  
Low Grade ◽  
White Matter Damage ◽  
Cranial Radiation ◽  
Pediatric Brain

20023 Purpose: To evaluate the delayed adverse changes in neuro-cognitive functions as well as white matter damage in radiated survivors of pediatric brain tumors. Methods: Forty two children (22 males) with primary brain tumors who were only treated with cranial radiation, were recruited. 28 patients were treated for low risk medulloblastoma, 10 patients for low grade astrocytoma, 3 patients for low grade ependymoma, and 1 patient for craniopharyngioma. Their ages ranged from 3 to 18 years (mean 10.3±3.98 years).They were subjected, initially just before radiotherapy and at follow-up 1–2 year after completion of cranial radiation, to serial clinical and neuropsychological assessments including Wechseler Intelligence Scale for Children, Vineland social maturity test, Benton Visual Memory Test, and Revised Behavior Problem Checklist. Magnetic resonance scans were also performed to detect the presence of white matter damage before radiotherapy and at follow up. Results: Initially, after surgery and before radiation, intelligence test scores were below normal scores for age and this was of high statistical significance (Total IQ: t= -3.02, P= 0.006). Visual memory test showed evidence of organicity in all cases. Social maturity showed a statistically significant decline as well (t= -2.11, P= 0.04). Follow-up after radiotherapy showed further decline with high statistical significance (Total IQ t= 3.228, P=0.003; visual memory t= 4.08, P= 0.001); An attentional problem has emerged (t= -6.12, P= 0.00). Both radiation dose and volume of radiation showed negative and statistically significant correlation with IQ. Age at diagnosis correlated positively and significantly with IQ ( r= 0.601, P=0.001). Multiple linear regression showed impaired neurocognitive function which was correlated with the degree of white matter damage. (standardized B= -0.577, P= 0.001) and young age at diagnosis (standardized B= -0.427, P= 0.014). Conclusions: Cranial radiation in pediatric brain tumors is associated with a decline in multiple neurocognitive functions including total IQ, visual memory, and attention; which are related to the toxic effect of cranial radiation on white matter of the brain especially in young age of childhood with high dose and whole cranial radiation. No significant financial relationships to disclose.

scholarly journals Comparison of Diffusion and Perfusion Techniques in Differentiating High Versus Low Grade Pediatric Brain Tumors

2020 ◽  
Vol 3 ◽  
Author(s):  
Eric Chen ◽  
Chang Ho ◽  
Benjamin Gray ◽  
Jason Parker ◽  
Emily Diller ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Tumor Grade ◽  
Pediatric Brain Tumors ◽  
Solid Cancer ◽  
Low Grade ◽  
Dynamic Susceptibility ◽  
High Grade ◽  
Dynamic Contrast Enhancement ◽  
Significant Difference ◽  
Pediatric Brain

Background/Objective: Brain tumors are the most common solid cancer in children and cause significant mortality and morbidity. We compare the effectiveness of different parameters in predicting tumor grade between dynamic contrast enhancement (DCE), intravoxel incoherent motion (IVIM), dynamic susceptibility contrast (DSC) perfusion and diffusion weighted imaging (DWI).    Methods: A retrospective blinded review of pediatric brain tumors with DCE, IVIM, DWI, and DSC was performed. Parametric maps were registered to T2 weighted images. Volumetric regions of interest (ROI) were manually segmented from solid tumor components for each patient by a neuroradiologist (CH), neuroradiology fellow (BG), and medical student (EC). Resulting mean values for parameters from DCE (Ktrans, Kep, Ve, Vp,), IVIM (D, D*, f), DSC (rCBV) and DWI (ADC) were compared using Student’s t-test for high- and low-grade tumor groups based on WHO grading from pathology. For significant parameters, receiver operating characteristic (ROC) analysis with area under curve (AUC) was performed.     Results: 20 subjects were included with 9 low grade and 11 high grade tumors. Significant differences between low versus high grade were demonstrated for D (10−3 mm2/s) (1.4±0.4 vs 0.9±0.2, p=0.01), f (0.04±0.02 vs 0.07±0.02, p=0.02), ADC (10−3 mm2/s) (1.4±0.4 vs 0.9±0.3, p=0.009) and rCBV (2.2±0.9 vs 4.7±2.1, p=0.003). No significant difference was found for D* or any DCE parameter. AUC from ROC was similar for all significant parameters [D (0.81, p=0.003); f (0.80, p=0.003); ADC (0.83, p=0.001); rCBV (0.83, p=0.0005)].    Conclusion: D and f parameters from IVIM can significantly differentiate high versus low grade pediatric brain tumors similar to ADC and rCBV. Conversely, no DCE parameter was significant.    Scientific Implications: The results will assist the selection of MRI sequences that best predict tumor grade, as well as guide tumor biopsy for the most aggressive tumor portions. Further study of these techniques may correlate with molecular profiling and predict outcome. 

scholarly journals LG-07 * MOSAIC GENETIC PROGRESSION MODELS OF LOW GRADE PEDIATRIC BRAIN TUMORS REVEAL UNIQUE FEATURES OF TUMOR EVOLUTION

2015 ◽  
Vol 17 (suppl 3) ◽  
pp. iii19-iii19
Author(s):  
C. D. Antonuk ◽  
R. Levy ◽  
J. Molina ◽  
M. Danielpour ◽  
A. Akhtar ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Pediatric Brain Tumors ◽  
Tumor Evolution ◽  
Low Grade ◽  
Pediatric Brain

Differentiating high and low grade pediatric brain tumors using diffusional kurtosis imaging

2015 ◽  
Vol 02 (04) ◽  
pp. 301-305
Author(s):  
Jens Jensen ◽  
Vitria Adisetiyo ◽  
Els Fieremans ◽  
Joseph Helpern ◽  
Matthias Karajannis ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Pediatric Brain Tumors ◽  
Low Grade ◽  
Diffusional Kurtosis Imaging ◽  
Pediatric Brain

scholarly journals Do Intratumoral And Peritumoral Apparent Diffusion Coefficient (ADC) Values Have A Role In The Diagnosis Of Pediatric Brain Tumors?

2020 ◽  
Author(s):  
Güleç Mert Doğan ◽  
Ahmet Sığırcı ◽  
Sevgi Taşolar ◽  
Aslınur Cengiz ◽  
Hilal Er Ulubaba ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Brain Tumors ◽  
Magnetic Resonance Image ◽  
Pediatric Patients ◽  
Pediatric Brain Tumors ◽  
Low Grade ◽  
High Grade ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Pediatric Brain

INTRODUCTION: The motion of water particles within biological tissues, which is called random Brownian motion, is detected at the microscopic level by Diffusion-Weighted Imaging (DWI) sequence of Magnetic Resonance Image technique. The Apparent Diffusion Coefficient (ADC) calculated on DWI has been used for tumor diagnosis and grading. The purpose of this study was to evaluate of ADC values in the differential diagnosis of supratentorial and infratentorial pediatric brain tumors and to reveal the difference of peritumoral ADC measurements of pediatric patients from adult patients. METHODS: All of the 56 pediatric patients included in this retrospective study had lesions >1 cm in diameter on magnetic resonance image and all of the diagnosies were confirmed by histopathology. Intratumoral and peritumoral ADC values and ratios were measured in diffusion weighted Magnetic Resonance Image. RESULTS: The 58.9% (n=33) of these tumors were supratentorial and 41.1% (n=23) were infratentorial. ADC values and ADC ratios were significantly lower in high-grade tumors than low-grade tumors (p<0.05). Peritumoral ADC values in high-grade tumors were lower than low grade tumors (p<0.05). The cut-off value of the ADC ratio between these two groups was 1 and the ADC cut-off value was 1.1*10-3 mm2/s. DISCUSSION AND CONCLUSION: In the differentiation of low and high-grade pediatric brain tumors, cut-off values of 1.1*10_3mm2/s for ADC Value and 1.0 for ADC Ratio may be useful. Although, peritumoral ADC values differ in children compared to the adult group, both intratumoral and peritumoral ADC values can help for grading pediatric brain tumors.

scholarly journals Advances in Targeted Therapies for Pediatric Brain Tumors

2020 ◽  
Vol 22 (12) ◽  
Author(s):  
Timothy Mueller ◽  
Ana Sofia Guerreiro Stucklin ◽  
Andreas Postlmayr ◽  
Sarah Metzger ◽  
Nicolas Gerber ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Targeted Therapies ◽  
Clinical Benefit ◽  
Pediatric Brain Tumors ◽  
Mapk Signaling ◽  
Mitogen Activated Protein Kinase ◽  
Molecular Heterogeneity ◽  
Low Grade ◽  
Combination Strategies ◽  
Pediatric Brain

Abstract Purpose of Review Over the last years, our understanding of the molecular biology of pediatric brain tumors has vastly improved. This has led to more narrowly defined subgroups of these tumors and has created new potential targets for molecularly driven therapies. This review presents an overview of the latest advances and challenges of implementing targeted therapies into the clinical management of pediatric brain tumors, with a focus on gliomas, craniopharyngiomas, and medulloblastomas. Recent Findings Pediatric low-grade gliomas (pLGG) show generally a low mutational burden with the mitogen-activated protein kinase (MAPK) signaling presenting a key driver for these tumors. Direct inhibition of this pathway through BRAF and/or MEK inhibitors has proven to be a clinically relevant strategy. More recently, MEK and IL-6 receptor inhibitors have started to be evaluated in the treatment for craniopharyngiomas. Aside these low-grade tumors, pediatric high-grade gliomas (pHGG) and medulloblastomas exhibit substantially greater molecular heterogeneity with various and sometimes unknown tumor driver alterations. The clinical benefit of different targeted therapy approaches to interfere with altered signaling pathways and restore epigenetic dysregulation is undergoing active clinical testing. For these multiple pathway-driven tumors, combination strategies will most likely be required to achieve clinical benefit. Summary The field of pediatric neuro-oncology made tremendous progress with regard to improved diagnosis setting the stage for precision medicine approaches over the last decades. The potential of targeted therapies has been clearly demonstrated for a subset of pediatric brain tumors. However, despite clear response rates, questions of sufficient blood-brain barrier penetration, optimal dosing, treatment duration as well as mechanisms of resistance and how these can be overcome with potential combination strategies need to be addressed in future investigations. Along this line, it is critical for future trials to define appropriate endpoints to assess therapy responses as well as short and long-term toxicities in the growing and developing child.

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