Purpose
Medulloblastoma is the most common malignant brain tumour in children [1]. Medulloblastomas arise in the cerebellum and have a propensity to disseminate throughout the whole central nervous system (CNS). Treatment consists of surgical resection, radiotherapy to the craniospinal axis (CSA) with a boost(additional dose) to the tumour bed in the posterior fossa, and multiagent chemotherapy. Five-year survival for standard risk, non-metastatic medulloblastoma is currently 70-80%. However, these patients frequently suffer from severe lifelong neurocognitive deficits which significantly and adversely impact their quality of life [2,3]....
Methods and materials
This is a retrospective review of 9 paediatric patients (a total of 39 scans) with medulloblastoma treated with surgery, photon radiotherapy and chemotherapy (Fig 1).[Fig 1] 2-year and 5-year follow up T2 MRIs were qualitatively analysed by a paediatric neuroradiologist (SA) based on the presence or absence of progressive T2 hyperintensity in the cerebellum (Fig 2).[Fig 2] Patients were grouped according to the presence or absence of progressive T2 signal change (PSC) at 2-years and 5-years on qualitative analysis.
For quantitative analysis, all the follow...
Results
Qualitative Analysis :
At 2 years, 7 patients qualitatively showed T2 hyperintensity (PSC) and 2 did not. At 5-years, 6 patients qualitatively showed PSC since the 2-year scan while 3 did not.
Quantitative Analysis :
When analysed at different time points after radiation, different texture features showed a significant difference between the 2 groups as shown in Fig 4, 5, and 6.[Fig 4][Fig 5][Fig 6]
There was no significant difference between feature values at time points C and E in 2-year PSC group and at...
Conclusion
Longitudinal texture analysis showed a significant difference in visibly normal regions of the dentate nucleus between patients with and without qualitative progressive signal changes at 2-year and 5-years. These differences in textural values were dynamic and different texture features showed significant differences at different times points over a 2-year period. Textural values also showed significant differences between groups when analysed cumulatively over a 2-year period.
Results of AUC after ROC analysis showed 9 texture features for the 2-year PSC group and 12 features for the...
Personal information and conflict of interest
P. U. Sakhavalkar:
Nothing to disclose
S. Avula:
Nothing to disclose
N. Thorp:
Nothing to disclose
B. Pizer:
Nothing to disclose
M. Jenkinson:
Nothing to disclose
References
Fossati P, Ricardi U and E Orecchia, Pediatric medulloblastoma: toxicity of current treatment and potential role of proton therapy. Cancer Treat Rev,2009. 35(1):p.79-96.
Gudrunardottir T et al, Treatment developments and the unfolding of the quality of life discussions in childhood medulloblastoma: a review. Childs Nerv Syst,2014. 30(6) p.979-90.
Packer R J and G Veniza, Management of and prognosis with medulloblastoma: therapy at a crossroads. Arch Neurol, 2008. 65(11):p.1419-24.
L Levisohn, A.C.G, J D Schmahmann, Neuropsychological consequences of cerebellar tumour resection in children- cerebellar cognitive affective...