Z Patay1, L A DeSain2, S N Hwang2, A Coan3, Y Li3, D W Ellison4. 1. From the Departments of Diagnostic Imaging (Z.P., L.A.D., S.N.H.) zoltan.patay@stjude.org. 2. From the Departments of Diagnostic Imaging (Z.P., L.A.D., S.N.H.). 3. Biostatistics (A.C., Y.L.). 4. Pathology (D.W.E.), St. Jude Children's Research Hospital, Memphis, Tennessee.
Abstract
BACKGROUND AND PURPOSE: "Transcriptionally different" medulloblastoma groups are associated with specific signaling pathway abnormalities; hence, they may present with distinct imaging manifestations. In this study, we sought to describe the MR imaging features of wingless-type-subgroup medulloblastomas with embryologic correlations. MATERIALS AND METHODS: Pre- and postoperative imaging studies of 16 patients with wingless-type-subgroup medulloblastoma were evaluated for tumor location, involvement of surrounding CSF spaces or parenchymal structures, conventional and DWI signal properties, and postsurgical damage patterns. Laterality scores were assigned to tumors at each step in the evaluation process. Continuous variables were summarized by using descriptive statistics. The Wilcoxon signed rank test was performed to compare laterality scores. To determine the interobserver variability, we computed the intraclass correlation and Cohen κ coefficients. RESULTS: Wingless-type-subgroup medulloblastomas in our series were histopathologically "classic." Wingless-type-subgroup medulloblastomas occur in specific sites, with involvement of the foramen of Luschka (75%), the fourth ventricle (68.75%), the cisterna magna (31.25%), and the cerebellopontine angle cistern (18.75%). Laterality scores were low (<2) when preoperative primary and secondary anatomic features were evaluated separately, but they increased (>2) when all pre- and postoperative anatomic features were considered. Results were statistically shown to be reproducible (interclass correlation coefficient, 0.71-0.94; Cohen κ, 0.63-1.00). On the basis of anatomic lesion patterns, 4 location-based subtypes may be distinguished: 1) midline-intraventricular, 2) midline-extraventricular, 3) off-midline-intraventricular, and 4) off-midline-extraventricular, which represent a continuum. CONCLUSIONS: Wingless-type-subgroup medulloblastomas are lateralized tumors arising from the brain stem and cerebellum around the foramen of Luschka. Our current understanding of their embryologic origins is in concordance with the spatial distribution of these tumors.
BACKGROUND AND PURPOSE: "Transcriptionally different" medulloblastoma groups are associated with specific signaling pathway abnormalities; hence, they may present with distinct imaging manifestations. In this study, we sought to describe the MR imaging features of wingless-type-subgroup medulloblastomas with embryologic correlations. MATERIALS AND METHODS: Pre- and postoperative imaging studies of 16 patients with wingless-type-subgroup medulloblastoma were evaluated for tumor location, involvement of surrounding CSF spaces or parenchymal structures, conventional and DWI signal properties, and postsurgical damage patterns. Laterality scores were assigned to tumors at each step in the evaluation process. Continuous variables were summarized by using descriptive statistics. The Wilcoxon signed rank test was performed to compare laterality scores. To determine the interobserver variability, we computed the intraclass correlation and Cohen κ coefficients. RESULTS: Wingless-type-subgroup medulloblastomas in our series were histopathologically "classic." Wingless-type-subgroup medulloblastomas occur in specific sites, with involvement of the foramen of Luschka (75%), the fourth ventricle (68.75%), the cisterna magna (31.25%), and the cerebellopontine angle cistern (18.75%). Laterality scores were low (<2) when preoperative primary and secondary anatomic features were evaluated separately, but they increased (>2) when all pre- and postoperative anatomic features were considered. Results were statistically shown to be reproducible (interclass correlation coefficient, 0.71-0.94; Cohen κ, 0.63-1.00). On the basis of anatomic lesion patterns, 4 location-based subtypes may be distinguished: 1) midline-intraventricular, 2) midline-extraventricular, 3) off-midline-intraventricular, and 4) off-midline-extraventricular, which represent a continuum. CONCLUSIONS: Wingless-type-subgroup medulloblastomas are lateralized tumors arising from the brain stem and cerebellum around the foramen of Luschka. Our current understanding of their embryologic origins is in concordance with the spatial distribution of these tumors.
Authors: David W Ellison; Mehmet Kocak; James Dalton; Hisham Megahed; Meryl E Lusher; Sarra L Ryan; Wei Zhao; Sarah Leigh Nicholson; Roger E Taylor; Simon Bailey; Steven C Clifford Journal: J Clin Oncol Date: 2010-10-04 Impact factor: 44.544
Authors: Julia Fruehwald-Pallamar; Stefan B Puchner; Andrea Rossi; Maria L Garre; Armando Cama; Claus Koelblinger; Anne G Osborn; Majda M Thurnher Journal: Neuroradiology Date: 2011-01-29 Impact factor: 2.804
Authors: Paul A Northcott; Andrey Korshunov; Hendrik Witt; Thomas Hielscher; Charles G Eberhart; Stephen Mack; Eric Bouffet; Steven C Clifford; Cynthia E Hawkins; Pim French; James T Rutka; Stefan Pfister; Michael D Taylor Journal: J Clin Oncol Date: 2010-09-07 Impact factor: 44.544
Authors: Kristen W Yeom; Bret C Mobley; Robert M Lober; Jalal B Andre; Sonia Partap; Hannes Vogel; Patrick D Barnes Journal: AJR Am J Roentgenol Date: 2013-04 Impact factor: 3.959
Authors: Vijay Ramaswamy; Marc Remke; Eric Bouffet; Claudia C Faria; Sebastien Perreault; Yoon-Jae Cho; David J Shih; Betty Luu; Adrian M Dubuc; Paul A Northcott; Ulrich Schüller; Sridharan Gururangan; Roger McLendon; Darell Bigner; Maryam Fouladi; Keith L Ligon; Scott L Pomeroy; Sandra Dunn; Joanna Triscott; Nada Jabado; Adam Fontebasso; David T W Jones; Marcel Kool; Matthias A Karajannis; Sharon L Gardner; David Zagzag; Sofia Nunes; José Pimentel; Jaume Mora; Eric Lipp; Andrew W Walter; Marina Ryzhova; Olga Zheludkova; Ella Kumirova; Jad Alshami; Sidney E Croul; James T Rutka; Cynthia Hawkins; Uri Tabori; Kari-Elise T Codispoti; Roger J Packer; Stefan M Pfister; Andrey Korshunov; Michael D Taylor Journal: Lancet Oncol Date: 2013-10-17 Impact factor: 41.316
Authors: Paul A Northcott; David T W Jones; Marcel Kool; Giles W Robinson; Richard J Gilbertson; Yoon-Jae Cho; Scott L Pomeroy; Andrey Korshunov; Peter Lichter; Michael D Taylor; Stefan M Pfister Journal: Nat Rev Cancer Date: 2012-12 Impact factor: 60.716
Authors: Wan-Yee Teo; Jianhe Shen; Jack Meng Fen Su; Alexander Yu; Jian Wang; Wing-Yuk Chow; Xiaonan Li; Jeremy Jones; Robert Dauser; William Whitehead; Adekunle M Adesina; Murali Chintagumpala; Tsz-Kwong Man; Ching C Lau Journal: Pediatr Blood Cancer Date: 2013-03-19 Impact factor: 3.167
Authors: S Perreault; V Ramaswamy; A S Achrol; K Chao; T T Liu; D Shih; M Remke; S Schubert; E Bouffet; P G Fisher; S Partap; H Vogel; M D Taylor; Y J Cho; K W Yeom Journal: AJNR Am J Neuroradiol Date: 2014-05-15 Impact factor: 3.825
Authors: Marcel Kool; Andrey Korshunov; Marc Remke; David T W Jones; Maria Schlanstein; Paul A Northcott; Yoon-Jae Cho; Jan Koster; Antoinette Schouten-van Meeteren; Dannis van Vuurden; Steven C Clifford; Torsten Pietsch; Andre O von Bueren; Stefan Rutkowski; Martin McCabe; V Peter Collins; Magnus L Bäcklund; Christine Haberler; Franck Bourdeaut; Olivier Delattre; Francois Doz; David W Ellison; Richard J Gilbertson; Scott L Pomeroy; Michael D Taylor; Peter Lichter; Stefan M Pfister Journal: Acta Neuropathol Date: 2012-02-23 Impact factor: 17.088
Authors: Deanna M Patmore; Amir Jassim; Erica Nathan; Reuben J Gilbertson; Daniel Tahan; Nadin Hoffmann; Yiai Tong; Kyle S Smith; Thirumala-Devi Kanneganti; Hiromichi Suzuki; Michael D Taylor; Paul Northcott; Richard J Gilbertson Journal: Dev Cell Date: 2020-06-17 Impact factor: 12.270
Authors: A Stock; M Mynarek; T Pietsch; S M Pfister; S C Clifford; T Goschzik; D Sturm; E C Schwalbe; D Hicks; S Rutkowski; B Bison; M Pham; M Warmuth-Metz Journal: AJNR Am J Neuroradiol Date: 2019-10-24 Impact factor: 3.825
Authors: M Iv; M Zhou; K Shpanskaya; S Perreault; Z Wang; E Tranvinh; B Lanzman; S Vajapeyam; N A Vitanza; P G Fisher; Y J Cho; S Laughlin; V Ramaswamy; M D Taylor; S H Cheshier; G A Grant; T Young Poussaint; O Gevaert; K W Yeom Journal: AJNR Am J Neuroradiol Date: 2018-12-06 Impact factor: 3.825
Authors: Rashad Jabarkheel; Nisreen Amayiri; Derek Yecies; Yuhao Huang; Sebastian Toescu; Liana Nobre; Donald J Mabbott; Sniya V Sudhakar; Prateek Malik; Suzanne Laughlin; Maisa Swaidan; Maysa Al Hussaini; Awni Musharbash; Geeta Chacko; Leni G Mathew; Paul G Fisher; Darren Hargrave; Ute Bartels; Uri Tabori; Stefan M Pfister; Kristian Aquilina; Michael D Taylor; Gerald A Grant; Eric Bouffet; Kshitij Mankad; Kristen W Yeom; Vijay Ramaswamy Journal: Neuro Oncol Date: 2020-02-20 Impact factor: 12.300
Authors: C A P F Alves; U Löbel; J S Martin-Saavedra; S Toescu; M H Tsunemi; S R Teixeira; K Mankad; D Hargrave; T S Jacques; C da Costa Leite; F G Gonçalves; A Vossough; F D'Arco Journal: AJNR Am J Neuroradiol Date: 2021-03-04 Impact factor: 3.825