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 GreinerStewart 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

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

11 Citations (Scopus)

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
Publication status	Published - 1 May 2022
Externally published	Yes

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10.1093/neuonc/noab245

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9071293/

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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

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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 = "Astrocytoma, Brain Stem Neoplasms/pathology, Glioma/diagnostic imaging, Glutamates, Humans, Registries",

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 - Astrocytoma

KW - Brain Stem Neoplasms/pathology

KW - Glioma/diagnostic imaging

KW - Glutamates

KW - Humans

KW - Registries

U2 - 10.1093/neuonc/noab245

DO - 10.1093/neuonc/noab245

M3 - Article

C2 - 34668975

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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