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Role of MRI in the management of children with diffuse pontine tumors: a study of 15 patients and review of the literature

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Abstract

Background: Pontine tumors carry the worst prognosis of all brain tumors. In most cases, the diagnosis is based solely on MR imaging, without biopsy. Objective: To describe the MR findings of pontine tumors at diagnosis and during follow-up and correlate those with prognosis and to assess the value of MR imaging in patient management compared to clinical evaluation. Materials and methods: Ninety-one MR scans of 15 children with diffuse pontine tumors were reviewed at diagnosis and during follow-up. The parameters analyzed were as follows: tumor extent, area, and volume; encasement of the basilar artery; presence of exophytic component; necrosis; cysts; hydrocephalus; and intensity and enhancement. Findings were correlated to length of progression-free and overall survival. Trends of amelioration or worsening on imaging were compared with the clinical findings. Results: Median length of progression-free survival was 10 months, and median survival was 20 months. Only hydrocephalus at presentation was associated with shorter progression-free survival (P=0.02). On the last examination of each patient, the craniocaudal diameter was significantly greater than at diagnosis (P=0.03). The concordance between the imaging and the clinical findings was good.Conclusion: MR is the mainstay for the diagnosis and management of pontine tumors. Cranial growth seems to be an ominous sign. However, the prognostic value of MR is limited. MR findings correlate well with the clinical examination.

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Acknowledgments

The authors thank Shlomo Michael and Zvi Cohen for their technical assistance and Pnina Lilos for statistical assistance.

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Authors and Affiliations

  1. Department of Imaging, Schneider Children’s Medical Center of Israel, Petah Tiqva, Israel

    Liora Kornreich, Michael Schwarz, Boaz Karmazyn & Gadi Horev

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Liora Kornreich, Michael Schwarz, Boaz Karmazyn, Ian J. Cohen, Avinoam Shuper, Shalom Michovitz, Issac Yaniv, Eyal Fenig & Gadi Horev

  3. Department of Hematology–Oncology, Schneider Children’s Medical Center of Israel, Petah Tiqva, Israel

    Ian J. Cohen, Avinoam Shuper & Issac Yaniv

  4. Department of Neurosurgery, Schneider Children’s Medical Center of Israel, Petah Tiqva, Israel

    Shalom Michovitz

  5. Institute of Oncology, Radiotherapy Unit, Rabin Medical Center,Beilinson Campus, Petah Tiqva, Israel

    Eyal Fenig

Authors
  1. Liora Kornreich
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  2. Michael Schwarz
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  3. Boaz Karmazyn
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  4. Ian J. Cohen
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  5. Avinoam Shuper
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  6. Shalom Michovitz
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  7. Issac Yaniv
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  8. Eyal Fenig
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  9. Gadi Horev
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Correspondence to Liora Kornreich.

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Kornreich, L., Schwarz, M., Karmazyn, B. et al. Role of MRI in the management of children with diffuse pontine tumors: a study of 15 patients and review of the literature. Pediatr Radiol 35, 872–879 (2005). https://doi.org/10.1007/s00247-005-1502-y

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  • DOI: https://doi.org/10.1007/s00247-005-1502-y

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