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Pediatric brain tumors can be classified noninvasively at diagnosis

Medulloblastoma subgroups can be identified using imaging techniques, allowing early intervention

Date:
August 7, 2015
Source:
Children's Hospital Los Angeles
Summary:
Medulloblastoma, the most commonly occurring malignant brain tumor in children, can be classified into four subgroups -- each with a different risk profile requiring subgroup-specific therapy. Investigators have now discovered that these subgroups can be determined non-invasively, using magnetic resonance spectroscopy.
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Medulloblastoma, the most commonly occurring malignant brain tumor in children, can be classified into four subgroups--each with a different risk profile requiring subgroup-specific therapy. Currently, subgroup determination is done after surgical removal of the tumor. Investigators at Children's Hospital Los Angeles have now discovered that these subgroups can be determined non-invasively, using magnetic resonance spectroscopy (MRS). The paper has been published online by the journal Neuro-Oncology.

"By identification of the tumor subgroup at the time of diagnosis, we will be able to begin specific therapy earlier," said Shahab Asgharzadeh, MD, of The Saban Research Institute of Children's Hospital Los Angeles, principal investigator on the study. Asgharzadeh is also an associate professor of Pediatrics and Pathology at the Keck School of Medicine of the University of Southern California (USC).

Treatment for medulloblastoma includes surgery, chemotherapy and radiation, with 5-year survival rates ranging from 30 to 90 percent depending upon risk profile. A recent discovery identified four subtypes of medulloblastoma (SHH, WNT, Group 3 and Group 4) with level of risk and clinical outcomes for each subtype varying significantly. Currently, classification requires surgical removal of the tumor followed by laboratory analysis of the tumor tissue. Given the clinical importance of subgroup determinations, a fast, reliable and easily accessible method could have a significant effect on the outcomes of children with this disease.

"MR spectroscopy is widely available, noninvasive and provides information on cellular metabolism, which is different in healthy and diseased tissue," said Stefan Bluml, PhD, investigator at The Saban Research Institute of CHLA and first author of the study. Bluml is also an associate professor of Research, Radiology and Biomedical Engineering at the Viterbi School of Engineering at USC.

Using frozen tumor tissue from 30 patients diagnosed with medulloblastoma, investigators performed subgroup analysis using standard techniques. These patients also had MRS performed at the time of diagnosis. With a screening panel composed of five metabolites, investigators found that the spectra for subgroups revealed distinct metabolic features, allowing them to differentiate subgroups SHH, WNT from Groups 3 and 4.

Clinical trials are being developed to incorporate molecular subgroups into risk and treatment stratifications. The ease of obtaining MRS at the time of diagnosis should allow its incorporation into future clinical trials aimed at validating this technique to improve diagnostic classification and, ultimately, improve outcomes in children with medulloblastoma.


Story Source:

Materials provided by Children's Hospital Los Angeles. Note: Content may be edited for style and length.


Journal Reference:

  1. Stefan Blüml, Ashley S. Margol, Richard Sposto, Rebekah J. Kennedy, Nathan J. Robison, Marzieh Vali, Long T. Hung, Sakunthala Muthugounder, Jonathan L. Finlay, Anat Erdreich-Epstein, Floyd H. Gilles, Alexander R. Judkins, Mark D. Krieger, Girish Dhall, Marvin D. Nelson, and Shahab Asgharzadeh. Molecular subgroups of medulloblastoma identification using noninvasive magnetic resonance spectroscopy. Neuro-Oncology, August 2015 DOI: 10.1093/neuonc/nov097

Cite This Page:

Children's Hospital Los Angeles. "Pediatric brain tumors can be classified noninvasively at diagnosis: Medulloblastoma subgroups can be identified using imaging techniques, allowing early intervention." ScienceDaily. ScienceDaily, 7 August 2015. <www.sciencedaily.com/releases/2015/08/150807144342.htm>.
Children's Hospital Los Angeles. (2015, August 7). Pediatric brain tumors can be classified noninvasively at diagnosis: Medulloblastoma subgroups can be identified using imaging techniques, allowing early intervention. ScienceDaily. Retrieved May 26, 2017 from www.sciencedaily.com/releases/2015/08/150807144342.htm
Children's Hospital Los Angeles. "Pediatric brain tumors can be classified noninvasively at diagnosis: Medulloblastoma subgroups can be identified using imaging techniques, allowing early intervention." ScienceDaily. www.sciencedaily.com/releases/2015/08/150807144342.htm (accessed May 26, 2017).

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