Advanced Magnetic Resonance Imaging in Pediatric Glioblastomas

The shortly upcoming 5th edition of the World Health Organization Classification of Tumors of the Central Nervous System is bringing extensive changes in the terminology of diffuse high-grade gliomas (DHGGs). Previously “glioblastoma,” as a descriptive entity, could have been applied to classify som...

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Autores principales:	Fabrício Guimarães Gonçalves, Angela N. Viaene, Arastoo Vossough
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	advanced MRI children conventional MRI diffusion-weighted imaging glioblastoma magnetic resonance spectroscopy Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/ef101a683dec4d0892709b22c28515e2
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spelling	oai:doaj.org-article:ef101a683dec4d0892709b22c28515e22021-11-10T06:01:21ZAdvanced Magnetic Resonance Imaging in Pediatric Glioblastomas1664-229510.3389/fneur.2021.733323https://doaj.org/article/ef101a683dec4d0892709b22c28515e22021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.733323/fullhttps://doaj.org/toc/1664-2295The shortly upcoming 5th edition of the World Health Organization Classification of Tumors of the Central Nervous System is bringing extensive changes in the terminology of diffuse high-grade gliomas (DHGGs). Previously “glioblastoma,” as a descriptive entity, could have been applied to classify some tumors from the family of pediatric or adult DHGGs. However, now the term “glioblastoma” has been divested and is no longer applied to tumors in the family of pediatric types of DHGGs. As an entity, glioblastoma remains, however, in the family of adult types of diffuse gliomas under the insignia of “glioblastoma, IDH-wildtype.” Of note, glioblastomas still can be detected in children when glioblastoma, IDH-wildtype is found in this population, despite being much more common in adults. Despite the separation from the family of pediatric types of DHGGs, what was previously labeled as “pediatric glioblastomas” still remains with novel labels and as new entities. As a result of advances in molecular biology, most of the previously called “pediatric glioblastomas” are now classified in one of the four family members of pediatric types of DHGGs. In this review, the term glioblastoma is still apocryphally employed mainly due to its historical relevance and the paucity of recent literature dealing with the recently described new entities. Therefore, “glioblastoma” is used here as an umbrella term in the attempt to encompass multiple entities such as astrocytoma, IDH-mutant (grade 4); glioblastoma, IDH-wildtype; diffuse hemispheric glioma, H3 G34-mutant; diffuse pediatric-type high-grade glioma, H3-wildtype and IDH-wildtype; and high grade infant-type hemispheric glioma. Glioblastomas are highly aggressive neoplasms. They may arise anywhere in the developing central nervous system, including the spinal cord. Signs and symptoms are non-specific, typically of short duration, and usually derived from increased intracranial pressure or seizure. Localized symptoms may also occur. The standard of care of “pediatric glioblastomas” is not well-established, typically composed of surgery with maximal safe tumor resection. Subsequent chemoradiation is recommended if the patient is older than 3 years. If younger than 3 years, surgery is followed by chemotherapy. In general, “pediatric glioblastomas” also have a poor prognosis despite surgery and adjuvant therapy. Magnetic resonance imaging (MRI) is the imaging modality of choice for the evaluation of glioblastomas. In addition to the typical conventional MRI features, i.e., highly heterogeneous invasive masses with indistinct borders, mass effect on surrounding structures, and a variable degree of enhancement, the lesions may show restricted diffusion in the solid components, hemorrhage, and increased perfusion, reflecting increased vascularity and angiogenesis. In addition, magnetic resonance spectroscopy has proven helpful in pre- and postsurgical evaluation. Lastly, we will refer to new MRI techniques, which have already been applied in evaluating adult glioblastomas, with promising results, yet not widely utilized in children.Fabrício Guimarães GonçalvesAngela N. ViaeneAngela N. ViaeneArastoo VossoughArastoo VossoughFrontiers Media S.A.articleadvanced MRIchildrenconventional MRIdiffusion-weighted imagingglioblastomamagnetic resonance spectroscopyNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	advanced MRI children conventional MRI diffusion-weighted imaging glioblastoma magnetic resonance spectroscopy Neurology. Diseases of the nervous system RC346-429
spellingShingle	advanced MRI children conventional MRI diffusion-weighted imaging glioblastoma magnetic resonance spectroscopy Neurology. Diseases of the nervous system RC346-429 Fabrício Guimarães Gonçalves Angela N. Viaene Angela N. Viaene Arastoo Vossough Arastoo Vossough Advanced Magnetic Resonance Imaging in Pediatric Glioblastomas
description	The shortly upcoming 5th edition of the World Health Organization Classification of Tumors of the Central Nervous System is bringing extensive changes in the terminology of diffuse high-grade gliomas (DHGGs). Previously “glioblastoma,” as a descriptive entity, could have been applied to classify some tumors from the family of pediatric or adult DHGGs. However, now the term “glioblastoma” has been divested and is no longer applied to tumors in the family of pediatric types of DHGGs. As an entity, glioblastoma remains, however, in the family of adult types of diffuse gliomas under the insignia of “glioblastoma, IDH-wildtype.” Of note, glioblastomas still can be detected in children when glioblastoma, IDH-wildtype is found in this population, despite being much more common in adults. Despite the separation from the family of pediatric types of DHGGs, what was previously labeled as “pediatric glioblastomas” still remains with novel labels and as new entities. As a result of advances in molecular biology, most of the previously called “pediatric glioblastomas” are now classified in one of the four family members of pediatric types of DHGGs. In this review, the term glioblastoma is still apocryphally employed mainly due to its historical relevance and the paucity of recent literature dealing with the recently described new entities. Therefore, “glioblastoma” is used here as an umbrella term in the attempt to encompass multiple entities such as astrocytoma, IDH-mutant (grade 4); glioblastoma, IDH-wildtype; diffuse hemispheric glioma, H3 G34-mutant; diffuse pediatric-type high-grade glioma, H3-wildtype and IDH-wildtype; and high grade infant-type hemispheric glioma. Glioblastomas are highly aggressive neoplasms. They may arise anywhere in the developing central nervous system, including the spinal cord. Signs and symptoms are non-specific, typically of short duration, and usually derived from increased intracranial pressure or seizure. Localized symptoms may also occur. The standard of care of “pediatric glioblastomas” is not well-established, typically composed of surgery with maximal safe tumor resection. Subsequent chemoradiation is recommended if the patient is older than 3 years. If younger than 3 years, surgery is followed by chemotherapy. In general, “pediatric glioblastomas” also have a poor prognosis despite surgery and adjuvant therapy. Magnetic resonance imaging (MRI) is the imaging modality of choice for the evaluation of glioblastomas. In addition to the typical conventional MRI features, i.e., highly heterogeneous invasive masses with indistinct borders, mass effect on surrounding structures, and a variable degree of enhancement, the lesions may show restricted diffusion in the solid components, hemorrhage, and increased perfusion, reflecting increased vascularity and angiogenesis. In addition, magnetic resonance spectroscopy has proven helpful in pre- and postsurgical evaluation. Lastly, we will refer to new MRI techniques, which have already been applied in evaluating adult glioblastomas, with promising results, yet not widely utilized in children.
format	article
author	Fabrício Guimarães Gonçalves Angela N. Viaene Angela N. Viaene Arastoo Vossough Arastoo Vossough
author_facet	Fabrício Guimarães Gonçalves Angela N. Viaene Angela N. Viaene Arastoo Vossough Arastoo Vossough
author_sort	Fabrício Guimarães Gonçalves
title	Advanced Magnetic Resonance Imaging in Pediatric Glioblastomas
title_short	Advanced Magnetic Resonance Imaging in Pediatric Glioblastomas
title_full	Advanced Magnetic Resonance Imaging in Pediatric Glioblastomas
title_fullStr	Advanced Magnetic Resonance Imaging in Pediatric Glioblastomas
title_full_unstemmed	Advanced Magnetic Resonance Imaging in Pediatric Glioblastomas
title_sort	advanced magnetic resonance imaging in pediatric glioblastomas
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/ef101a683dec4d0892709b22c28515e2
work_keys_str_mv	AT fabricioguimaraesgoncalves advancedmagneticresonanceimaginginpediatricglioblastomas AT angelanviaene advancedmagneticresonanceimaginginpediatricglioblastomas AT angelanviaene advancedmagneticresonanceimaginginpediatricglioblastomas AT arastoovossough advancedmagneticresonanceimaginginpediatricglioblastomas AT arastoovossough advancedmagneticresonanceimaginginpediatricglioblastomas
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Advanced Magnetic Resonance Imaging in Pediatric Glioblastomas

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