Discrimination Between Glioblastoma and Solitary Brain Metastasis Using Conventional MRI and Diffusion-Weighted Imaging Based on a Deep Learning Algorithm

Objective This study compared the dynamic susceptibility contrast (DSC) magnetic resonance imaging parameters and apparent diffusion coefficient (ADC) between pilocytic astrocytoma (PA) and diffuse midline glioma, H3K27-altered (DMG) variants. Methods The normalized relative cerebral blood volume (nrCBV), normalized relative flow (nrCBF), percentile signal recovery (PSR), and normalized mean ADC (nADCmean) of 23 patients with midline PAs (median age, 13 years [range, 1–71 years]; 13 female patients) and 40 patients with DMG (8.5 years [1–35 years]; 19 female patients), including 35 patients with H3.3- and five patients with H3.1-mutant tumors, treated between January 2016 and May 2022 were statistically compared. Results DMG had a significantly lower nADCmean (median: 1.48 vs. 1.96; p = 0.00075) and lower PSR (0.97 vs. 1.23, p = 0.13) but higher nrCBV and nrCBF (1.66 vs. 1.17, p = 0.058, respectively, and 1.87 vs. 1.19, p = 0.028, respectively) than PA. The H3.3 variant had a lower nADCmean than the H3.1 variant (1.46 vs. 1.80, p = 0.10). Conclusion DMG had lower ADC and PSR and higher rCBV and rCBF than PA. The H3.3 variant had a lower ADC than the H3.1 variant. Recognizing the differences and similarities in the DSC parameters and ADC between these tumors may help presurgical diagnosis.

Dynamic susceptibility contrast perfusion-weighted and diffusion-weighted magnetic resonance imaging findings in pilocytic astrocytoma and H3.3 and H3.1 variant diffuse midline glioma, H3K27-altered

Background, Ependymal tumors are uncommon in intracranial tumors. Ependymal origin usually involves an intraventricular localization. Exceptional intraparenchymal extra ventricular locations have been described. We report a case of extra ventricular ependymoma managed in our department. 
Description du cas. Une fillette de 8 ans a été admise pour une hémiparésie gauche qui progressait depuis deux semaines associée à des maux de tête chroniques. L’examen neurologique a noté une force musculaire évaluée à 4/5 dans l’hémicorps gauche. L’imagerie médicale a permis de mettre en évidence une masse pariétale temporale droite volumineuse mixte, intraparenchymateuse, évoquant d’abord un astrocytome diffus (grade II de l’OMS). Après excision totale macroscopique, l’histologie et l’immunohistochimie ont conclu qu’il s’agissait d’un épendymome de grade II de l’OMS. Cinq mois après l’opération, le patient était asymptomatique et la tomodensitométrie de contrôle n’était pas remarquable. Après un suivi de 4 ans, le patient est resté asymptomatique. 
Conclusion. Le diagnostic d’épendymome extraventriculaire était une surprise histologique. L’ablation chirurgicale de cette lésion n’était pas un problème. Le cours était satisfaisant en l’absence de traitement adjuvant (chimiothérapie et/ou radiothérapie).

/pdf/supratentorial-extra-ventricular-intraparenchymal-ependymoma-186fsqs1.pdf

Supratentorial extra ventricular intraparenchymal ependymoma in a child

BackgroundThe differentiation of supratentorial pilocytic astrocytomas (STPAs) and supratentorial extraventricular ependymomas (STEEs) is clinically pivotal because of distinct therapeutic manageme...

Differentiation between supratentorial pilocytic astrocytoma and extraventricular ependymoma using multiparametric MRI.

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Differentiation between supratentorial pilocytic astrocytoma and extraventricular ependymoma using multiparametric MRI.