Accuracy of central neuro-imaging review of DIPG compared with histopathology in the International DIPG Registry

Margot A. Lazow; Christine Fuller; Mariko Dewire; Adam Lane; Pratiti Bandopadhayay; Ute Bartels; Eric Bouffet; Sylvia Cheng; Kenneth J. Cohen; Tabitha M. Cooney; Scott L. Coven; Hetal Dholaria; Blanca Diez; Kathleen Dorris; Moatasem El-Ayadi; Ayman El-Sheikh; Paul G. Fisher; Adriana Fonseca; Mercedes Garcia Lombardi; Robert J. Greiner; Stewart Goldman; Nicholas Gottardo; Sridharan Gururangan; Jordan R. Hansford; Tim Hassall; Cynthia Hawkins; Lindsay Kilburn; Carl Koschmann; Sarah E. Leary; Jie Ma; Jane E. Minturn; Michelle Monje-Deisseroth; Roger Packer; Yvan Samson; Eric S. Sandler; Gustavo Sevlever; Christopher L. Tinkle; Karen Tsui; Lars M. Wagner; Mohamed Zaghloul; David S. Ziegler; Brooklyn Chaney; Katie Black; Anthony Asher; Rachid Drissi; Maryam Fouladi; Blaise V. Jones; James L. Leach

doi:10.1093/neuonc/noab245

Accuracy of central neuro-imaging review of DIPG compared with histopathology in the International DIPG Registry

Margot A. Lazow
, Christine Fuller
, Mariko Dewire
, Adam Lane
, Pratiti Bandopadhayay
, Ute Bartels
, Eric Bouffet
, Sylvia Cheng
, Kenneth J. Cohen
, Tabitha M. Cooney
, Scott L. Coven
, Hetal Dholaria
, Blanca Diez
, Kathleen Dorris
, Moatasem El-Ayadi
, Ayman El-Sheikh
, Paul G. Fisher
, Adriana Fonseca
, Mercedes Garcia Lombardi
, Robert J. Greiner

Stewart Goldman, Nicholas Gottardo, Sridharan Gururangan, Jordan R. Hansford, Tim Hassall, Cynthia Hawkins, Lindsay Kilburn, Carl Koschmann, Sarah E. Leary, Jie Ma, Jane E. Minturn, Michelle Monje-Deisseroth, Roger Packer, Yvan Samson, Eric S. Sandler, Gustavo Sevlever, Christopher L. Tinkle, Karen Tsui, Lars M. Wagner, Mohamed Zaghloul, David S. Ziegler, Brooklyn Chaney, Katie Black, Anthony Asher, Rachid Drissi, Maryam Fouladi, Blaise V. Jones, James L. Leach

Cincinnati Children's Hospital Medical Center
Nationwide Children’s Hospital
Ohio State University
SUNY Upstate Medical University
Dana-Farber Cancer Institute
University of Toronto
University of British Columbia
Johns Hopkins University
Riley Hospital for Children
Perth Children's Hospital
Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia
The Children's Hospital, Aurora
Cairo University
Dayton Children's Hospital
Stanford University
Pediatric Hospital R. Gutierrez
Pennsylvania State University
University of Arizona
University of Florida
University of Melbourne
Children’s Health Queensland
Children's National Medical Center
University of Michigan, Ann Arbor
Seattle Children's
Shanghai Jiao Tong University
The Children's Hospital of Philadelphia
University of Kentucky
University of New South Wales
University of Montreal
St. Jude Children Research Hospital
Auckland District Health Board
University of Cincinnati

Research output: Contribution to journal › Article › peer-review

15 Scopus citations

Abstract

Background: Diffuse intrinsic pontine glioma (DIPG) remains a clinico-radiologic diagnosis without routine tissue acquisition. Reliable imaging distinction between DIPG and other pontine tumors with potentially more favorable prognoses and treatment considerations is essential. Methods: Cases submitted to the International DIPG registry (IDIPGR) with histopathologic and/or radiologic data were analyzed. Central imaging review was performed on diagnostic brain MRIs (if available) by two neuro-radiologists. Imaging features suggestive of alternative diagnoses included nonpontine origin, <50% pontine involvement, focally exophytic morphology, sharply defined margins, and/or marked diffusion restriction throughout. Results: Among 286 patients with pathology from biopsy and/or autopsy, 23 (8%) had histologic diagnoses inconsistent with DIPG, most commonly nondiffuse low-grade gliomas and embryonal tumors. Among 569 patients with centrally-reviewed diagnostic MRIs, 40 (7%) were classified as non-DIPG, alternative diagnosis suspected. The combined analysis included 151 patients with both histopathology and centrally-reviewed MRI. Of 77 patients with imaging classified as characteristic of DIPG, 76 (99%) had histopathologic diagnoses consistent with DIPG (infiltrating grade II-IV gliomas). Of 57 patients classified as likely DIPG with some unusual imaging features, 55 (96%) had histopathologic diagnoses consistent with DIPG. Of 17 patients with imaging features suggestive of an alternative diagnosis, eight (47%) had histopathologic diagnoses inconsistent with DIPG (remaining patients were excluded due to nonpontine tumor origin). Association between central neuro-imaging review impression and histopathology was significant (p < 0.001), and central neuro-imaging impression was prognostic of overall survival. Conclusions: The accuracy and important role of central neuro-imaging review in confirming the diagnosis of DIPG is demonstrated.

Original language	English
Pages (from-to)	821-833
Number of pages	13
Journal	Neuro-Oncology
Volume	24
Issue number	5
DOIs	https://doi.org/10.1093/neuonc/noab245
State	Published - 1 May 2022

Keywords

DIPG
central imaging review
histopathology
non-DIPG
pontine tumor

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10.1093/neuonc/noab245

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Lazow, M. A., Fuller, C., Dewire, M., Lane, A., Bandopadhayay, P., Bartels, U., Bouffet, E., Cheng, S., Cohen, K. J., Cooney, T. M., Coven, S. L., Dholaria, H., Diez, B., Dorris, K., El-Ayadi, M., El-Sheikh, A., Fisher, P. G., Fonseca, A., Garcia Lombardi, M., ... Leach, J. L. (2022). Accuracy of central neuro-imaging review of DIPG compared with histopathology in the International DIPG Registry. Neuro-Oncology, 24(5), 821-833. https://doi.org/10.1093/neuonc/noab245

@article{2108e8b784474db7b3e71b01f11f973f,

title = "Accuracy of central neuro-imaging review of DIPG compared with histopathology in the International DIPG Registry",

abstract = "Background: Diffuse intrinsic pontine glioma (DIPG) remains a clinico-radiologic diagnosis without routine tissue acquisition. Reliable imaging distinction between DIPG and other pontine tumors with potentially more favorable prognoses and treatment considerations is essential. Methods: Cases submitted to the International DIPG registry (IDIPGR) with histopathologic and/or radiologic data were analyzed. Central imaging review was performed on diagnostic brain MRIs (if available) by two neuro-radiologists. Imaging features suggestive of alternative diagnoses included nonpontine origin, <50\% pontine involvement, focally exophytic morphology, sharply defined margins, and/or marked diffusion restriction throughout. Results: Among 286 patients with pathology from biopsy and/or autopsy, 23 (8\%) had histologic diagnoses inconsistent with DIPG, most commonly nondiffuse low-grade gliomas and embryonal tumors. Among 569 patients with centrally-reviewed diagnostic MRIs, 40 (7\%) were classified as non-DIPG, alternative diagnosis suspected. The combined analysis included 151 patients with both histopathology and centrally-reviewed MRI. Of 77 patients with imaging classified as characteristic of DIPG, 76 (99\%) had histopathologic diagnoses consistent with DIPG (infiltrating grade II-IV gliomas). Of 57 patients classified as likely DIPG with some unusual imaging features, 55 (96\%) had histopathologic diagnoses consistent with DIPG. Of 17 patients with imaging features suggestive of an alternative diagnosis, eight (47\%) had histopathologic diagnoses inconsistent with DIPG (remaining patients were excluded due to nonpontine tumor origin). Association between central neuro-imaging review impression and histopathology was significant (p < 0.001), and central neuro-imaging impression was prognostic of overall survival. Conclusions: The accuracy and important role of central neuro-imaging review in confirming the diagnosis of DIPG is demonstrated.",

keywords = "DIPG, central imaging review, histopathology, non-DIPG, pontine tumor",

author = "Lazow, \{Margot A.\} and Christine Fuller and Mariko Dewire and Adam Lane and Pratiti Bandopadhayay and Ute Bartels and Eric Bouffet and Sylvia Cheng and Cohen, \{Kenneth J.\} and Cooney, \{Tabitha M.\} and Coven, \{Scott L.\} and Hetal Dholaria and Blanca Diez and Kathleen Dorris and Moatasem El-Ayadi and Ayman El-Sheikh and Fisher, \{Paul G.\} and Adriana Fonseca and \{Garcia Lombardi\}, Mercedes and Greiner, \{Robert J.\} and Stewart Goldman and Nicholas Gottardo and Sridharan Gururangan and Hansford, \{Jordan R.\} and Tim Hassall and Cynthia Hawkins and Lindsay Kilburn and Carl Koschmann and Leary, \{Sarah E.\} and Jie Ma and Minturn, \{Jane E.\} and Michelle Monje-Deisseroth and Roger Packer and Yvan Samson and Sandler, \{Eric S.\} and Gustavo Sevlever and Tinkle, \{Christopher L.\} and Karen Tsui and Wagner, \{Lars M.\} and Mohamed Zaghloul and Ziegler, \{David S.\} and Brooklyn Chaney and Katie Black and Anthony Asher and Rachid Drissi and Maryam Fouladi and Jones, \{Blaise V.\} and Leach, \{James L.\}",

year = "2022",

month = may,

day = "1",

doi = "10.1093/neuonc/noab245",

language = "English",

volume = "24",

pages = "821--833",

journal = "Neuro-Oncology",

issn = "1522-8517",

publisher = "Oxford University Press",

number = "5",

}

Lazow, MA, Fuller, C, Dewire, M, Lane, A, Bandopadhayay, P, Bartels, U, Bouffet, E, Cheng, S, Cohen, KJ, Cooney, TM, Coven, SL, Dholaria, H, Diez, B, Dorris, K, El-Ayadi, M, El-Sheikh, A, Fisher, PG, Fonseca, A, Garcia Lombardi, M, Greiner, RJ, Goldman, S, Gottardo, N, Gururangan, S, Hansford, JR, Hassall, T, Hawkins, C, Kilburn, L, Koschmann, C, Leary, SE, Ma, J, Minturn, JE, Monje-Deisseroth, M, Packer, R, Samson, Y, Sandler, ES, Sevlever, G, Tinkle, CL, Tsui, K, Wagner, LM, Zaghloul, M, Ziegler, DS, Chaney, B, Black, K, Asher, A, Drissi, R, Fouladi, M, Jones, BV & Leach, JL 2022, 'Accuracy of central neuro-imaging review of DIPG compared with histopathology in the International DIPG Registry', Neuro-Oncology, vol. 24, no. 5, pp. 821-833. https://doi.org/10.1093/neuonc/noab245

TY - JOUR

T1 - Accuracy of central neuro-imaging review of DIPG compared with histopathology in the International DIPG Registry

AU - Lazow, Margot A.

AU - Fuller, Christine

AU - Dewire, Mariko

AU - Lane, Adam

AU - Bandopadhayay, Pratiti

AU - Bartels, Ute

AU - Bouffet, Eric

AU - Cheng, Sylvia

AU - Cohen, Kenneth J.

AU - Cooney, Tabitha M.

AU - Coven, Scott L.

AU - Dholaria, Hetal

AU - Diez, Blanca

AU - Dorris, Kathleen

AU - El-Ayadi, Moatasem

AU - El-Sheikh, Ayman

AU - Fisher, Paul G.

AU - Fonseca, Adriana

AU - Garcia Lombardi, Mercedes

AU - Greiner, Robert J.

AU - Goldman, Stewart

AU - Gottardo, Nicholas

AU - Gururangan, Sridharan

AU - Hansford, Jordan R.

AU - Hassall, Tim

AU - Hawkins, Cynthia

AU - Kilburn, Lindsay

AU - Koschmann, Carl

AU - Leary, Sarah E.

AU - Ma, Jie

AU - Minturn, Jane E.

AU - Monje-Deisseroth, Michelle

AU - Packer, Roger

AU - Samson, Yvan

AU - Sandler, Eric S.

AU - Sevlever, Gustavo

AU - Tinkle, Christopher L.

AU - Tsui, Karen

AU - Wagner, Lars M.

AU - Zaghloul, Mohamed

AU - Ziegler, David S.

AU - Chaney, Brooklyn

AU - Black, Katie

AU - Asher, Anthony

AU - Drissi, Rachid

AU - Fouladi, Maryam

AU - Jones, Blaise V.

AU - Leach, James L.

PY - 2022/5/1

Y1 - 2022/5/1

N2 - Background: Diffuse intrinsic pontine glioma (DIPG) remains a clinico-radiologic diagnosis without routine tissue acquisition. Reliable imaging distinction between DIPG and other pontine tumors with potentially more favorable prognoses and treatment considerations is essential. Methods: Cases submitted to the International DIPG registry (IDIPGR) with histopathologic and/or radiologic data were analyzed. Central imaging review was performed on diagnostic brain MRIs (if available) by two neuro-radiologists. Imaging features suggestive of alternative diagnoses included nonpontine origin, <50% pontine involvement, focally exophytic morphology, sharply defined margins, and/or marked diffusion restriction throughout. Results: Among 286 patients with pathology from biopsy and/or autopsy, 23 (8%) had histologic diagnoses inconsistent with DIPG, most commonly nondiffuse low-grade gliomas and embryonal tumors. Among 569 patients with centrally-reviewed diagnostic MRIs, 40 (7%) were classified as non-DIPG, alternative diagnosis suspected. The combined analysis included 151 patients with both histopathology and centrally-reviewed MRI. Of 77 patients with imaging classified as characteristic of DIPG, 76 (99%) had histopathologic diagnoses consistent with DIPG (infiltrating grade II-IV gliomas). Of 57 patients classified as likely DIPG with some unusual imaging features, 55 (96%) had histopathologic diagnoses consistent with DIPG. Of 17 patients with imaging features suggestive of an alternative diagnosis, eight (47%) had histopathologic diagnoses inconsistent with DIPG (remaining patients were excluded due to nonpontine tumor origin). Association between central neuro-imaging review impression and histopathology was significant (p < 0.001), and central neuro-imaging impression was prognostic of overall survival. Conclusions: The accuracy and important role of central neuro-imaging review in confirming the diagnosis of DIPG is demonstrated.

AB - Background: Diffuse intrinsic pontine glioma (DIPG) remains a clinico-radiologic diagnosis without routine tissue acquisition. Reliable imaging distinction between DIPG and other pontine tumors with potentially more favorable prognoses and treatment considerations is essential. Methods: Cases submitted to the International DIPG registry (IDIPGR) with histopathologic and/or radiologic data were analyzed. Central imaging review was performed on diagnostic brain MRIs (if available) by two neuro-radiologists. Imaging features suggestive of alternative diagnoses included nonpontine origin, <50% pontine involvement, focally exophytic morphology, sharply defined margins, and/or marked diffusion restriction throughout. Results: Among 286 patients with pathology from biopsy and/or autopsy, 23 (8%) had histologic diagnoses inconsistent with DIPG, most commonly nondiffuse low-grade gliomas and embryonal tumors. Among 569 patients with centrally-reviewed diagnostic MRIs, 40 (7%) were classified as non-DIPG, alternative diagnosis suspected. The combined analysis included 151 patients with both histopathology and centrally-reviewed MRI. Of 77 patients with imaging classified as characteristic of DIPG, 76 (99%) had histopathologic diagnoses consistent with DIPG (infiltrating grade II-IV gliomas). Of 57 patients classified as likely DIPG with some unusual imaging features, 55 (96%) had histopathologic diagnoses consistent with DIPG. Of 17 patients with imaging features suggestive of an alternative diagnosis, eight (47%) had histopathologic diagnoses inconsistent with DIPG (remaining patients were excluded due to nonpontine tumor origin). Association between central neuro-imaging review impression and histopathology was significant (p < 0.001), and central neuro-imaging impression was prognostic of overall survival. Conclusions: The accuracy and important role of central neuro-imaging review in confirming the diagnosis of DIPG is demonstrated.

KW - DIPG

KW - central imaging review

KW - histopathology

KW - non-DIPG

KW - pontine tumor

UR - https://www.scopus.com/pages/publications/85130461106

U2 - 10.1093/neuonc/noab245

DO - 10.1093/neuonc/noab245

M3 - Article

C2 - 34668975

AN - SCOPUS:85130461106

SN - 1522-8517

VL - 24

SP - 821

EP - 833

JO - Neuro-Oncology

JF - Neuro-Oncology

IS - 5

ER -

Accuracy of central neuro-imaging review of DIPG compared with histopathology in the International DIPG Registry

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Keywords

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