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

School of Medicine

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

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 (US)
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 - May 1 2022

Keywords

DIPG
central imaging review
histopathology
non-DIPG
pontine tumor

ASJC Scopus subject areas

Clinical Neurology
Oncology
Cancer Research

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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

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

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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 = "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 (US)",

volume = "24",

pages = "821--833",

journal = "Neuro-oncology",

issn = "1522-8517",

publisher = "Oxford University Press",

number = "5",

}

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

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AN - SCOPUS:85130461106

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

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