ADC Histogram Analysis of Pediatric Low-Grade Glioma Treated with Selumetinib: A Report from the Pediatric Brain Tumor Consortium.

Journal Article (Journal Article)

BACKGROUND AND PURPOSE: Selumetinib is a promising MAP (mitogen-activated protein) kinase (MEK) 1/2 inhibitor treatment for pediatric low-grade gliomas. We hypothesized that MR imaging-derived ADC histogram metrics would be associated with survival and response to treatment with selumetinib. MATERIALS AND METHODS: Children with recurrent, refractory, or progressive pediatric low-grade gliomas who had World Health Organization grade I pilocytic astrocytoma with KIAA1549-BRAF fusion or the BRAF V600E mutation (stratum 1), neurofibromatosis type 1-associated pediatric low-grade gliomas (stratum 3), or sporadic non-neurofibromatosis type 1 optic pathway and hypothalamic glioma (OPHG) (stratum 4) were treated with selumetinib for up to 2 years. Quantitative ADC histogram metrics were analyzed for total and enhancing tumor volumes at baseline and during treatment. RESULTS: Each stratum comprised 25 patients. Stratum 1 responders showed lower values of SD of baseline ADC_total as well as a larger decrease with time on treatment in ADC_total mean, mode, and median compared with nonresponders. Stratum 3 responders showed a greater longitudinal decrease in ADC_total. In stratum 4, higher baseline ADC_total skewness and kurtosis were associated with shorter progression-free survival. When all 3 strata were combined, responders showed a greater decrease with time in ADC_total mode and median. Compared with sporadic OPHG, neurofibromatosis type 1-associated OPHG had lower values of ADC_total mean, mode, and median as well as ADC_enhancement mean and median and higher values of ADC_total skewness and kurtosis at baseline. The longitudinal decrease in ADC_total median during treatment was significantly greater in sporadic OPHG compared with neurofibromatosis type 1-associated OPHG. CONCLUSIONS: ADC histogram metrics are associated with progression-free survival and response to treatment with selumetinib in pediatric low-grade gliomas.

Full Text

Duke Authors

Cited Authors

  • Vajapeyam, S; Brown, D; Ziaei, A; Wu, S; Vezina, G; Stern, JS; Panigrahy, A; Patay, Z; Tamrazi, B; Jones, JY; Haque, SS; Enterline, DS; Cha, S; Jones, BV; Yeom, KW; Onar-Thomas, A; Dunkel, IJ; Fouladi, M; Fangusaro, JR; Poussaint, TY

Published Date

  • March 2022

Published In

Volume / Issue

  • 43 / 3

Start / End Page

  • 455 - 461

PubMed ID

  • 35210278

Pubmed Central ID

  • PMC8910799

Electronic International Standard Serial Number (EISSN)

  • 1936-959X

Digital Object Identifier (DOI)

  • 10.3174/ajnr.A7433


  • eng

Conference Location

  • United States