Imaging Biomarkers for Adult Medulloblastomas: Genetic Entities May Be Identified by Their MR Imaging Radiophenotype

The occurrence of medulloblastomas in adults is rare; nevertheless, these tumors can be subdivided into genetic and histologic entities each having distinct prognoses. This study aimed to identify MR imaging biomarkers to classify these entities and to uncover differences in MR imaging biomarkers id...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2017-10, Vol.38 (10), p.1892-1898
Main Authors: Keil, V C, Warmuth-Metz, M, Reh, C, Enkirch, S J, Reinert, C, Beier, D, Jones, D T W, Pietsch, T, Schild, H H, Hattingen, E, Hau, P
Format: Article
Language:English
Subjects:
Adult
Adult Brain
Adults
Biomarkers
Cerebellar Neoplasms - diagnostic imaging
Cerebellar Neoplasms - genetics
Cerebellar Neoplasms - pathology
Children
Clinical Trials as Topic
Cohort Studies
Criteria
Edema
Female
Genetic Markers
Hedgehog protein
Hemorrhage
Humans
Hydrocephalus
Lesions
Magnetic Resonance Imaging
Male
Medulloblastoma
Medulloblastoma - diagnostic imaging
Medulloblastoma - genetics
Medulloblastoma - pathology
Middle Aged
Neuroimaging
p53 Protein
Pediatrics
Physical characteristics
Pilot Projects
Prognosis
Retrospective Studies
Sensitivity and Specificity
Tumors
Ventricle
Ventricles (cerebral)
Wnt protein
Young Adult
β-Catenin
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Description
Summary:The occurrence of medulloblastomas in adults is rare; nevertheless, these tumors can be subdivided into genetic and histologic entities each having distinct prognoses. This study aimed to identify MR imaging biomarkers to classify these entities and to uncover differences in MR imaging biomarkers identified in pediatric medulloblastomas. Eligible preoperative MRIs from 28 patients (11 women; 22-53 years of age) of the Multicenter Pilot-study for the Therapy of Medulloblastoma of Adults (NOA-7) cohort were assessed by 3 experienced neuroradiologists. Lesions and perifocal edema were volumetrized and multiparametrically evaluated for classic morphologic characteristics, location, hydrocephalus, and Chang criteria. To identify MR imaging biomarkers, we correlated genetic entities ( ) wild type, ( ), and non non medulloblastomas (in adults, Group 4), and histologic entities were correlated with the imaging criteria. These MR imaging biomarkers were compared with corresponding data from a pediatric study. There were 19 wild type (69%), 4 -activated (14%), and 5 Group 4 (17%) medulloblastomas. Six potential MR imaging biomarkers were identified, 3 of which, hydrocephalus ( = .03), intraventricular macrometastases ( = .02), and hemorrhage ( = .04), when combined, could identify medulloblastoma with 100% sensitivity and 88.3% specificity (95% CI, 39.8%-100.0% and 62.6%-95.3%). -activated nuclear β-catenin accumulating medulloblastomas were smaller than the other entities (95% CI, 5.2-22.3 cm versus 35.1-47.6 cm ; = .03). Hemorrhage was exclusively present in non non medulloblastomas ( = .04; = 2/5). MR imaging biomarkers were all discordant from those identified in the pediatric cohort. Desmoplastic/nodular medulloblastomas were more rarely in contact with the fourth ventricle (4/15 versus 7/13; = .04). MR imaging biomarkers can help distinguish histologic and genetic medulloblastoma entities in adults and appear to be different from those identified in children.
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A5313