Jeng-Dau Tsai1,2, Chang-Ching Wei3,4, Teng-Fu Tsao1,5, Yu-Ping Hsiao1,6, Henry J Tsai7, Sheng-Hui Yang8, Min-Ling Tsai1,9, Ji-Nan Sheu10,11. 1. School of Medicine, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung, 402, Taiwan. 2. Department of Pediatrics, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung, 402, Taiwan. 3. Children's Hospital, China Medical University Hospital, Taichung, Taiwan. 4. School of Medicine, China Medical University, Taichung, Taiwan. 5. Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan. 6. Department of Dermatology, Chung Shan Medical University Hospital, Taichung, Taiwan. 7. Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan. 8. Department of Life Sciences, National Chung Hsing University, Taichung, Taiwan. 9. Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan. 10. School of Medicine, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung, 402, Taiwan. cshy098@csh.org.tw. 11. Department of Pediatrics, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung, 402, Taiwan. cshy098@csh.org.tw.
Abstract
PURPOSE: The most common neurological complications associated with tuberous sclerosis complex (TSC) include intractable seizures that begin in infancy and subependymal giant cell astrocytoma (SEGA) complicated by hydrocephalus with increasing age. Information on SEGA growth of TSC patients is limited. This study aimed to examine the TSC-SEGA growth rates by periodic neuroimaging. METHODS: This study evaluated the TSC-SEGA growth rates by serial neuroimaging. Fifty-eight patients with TSC underwent systematic evaluation, including a review of medical history and serial brain neuroimaging. RESULTS: While magnetic resonance imaging was more sensitive in detecting cortical tubers than computed tomography (73.1 vs. 0 %, p < 0.001), its efficacy in identifying intracranial lesions was comparable to that of computed tomography (96.2 vs. 100 %, p = 0.658). Significant tumor growth was observed in children (p = 0.012) and adults (p = 0.028) during follow-up periods, respectively (median for children 23.5 months, interquartile range 18-40 months and median for adults 23 months, interquartile range 12-34 months). Further, the SEGA growth rate in children was significantly higher than that in adults (75.6 vs. 16.5 %, p = 0.03). CONCLUSIONS: The results of the study show that SEGA has a significantly higher growth rate in children using serial follow-up brain imaging, suggesting the importance of performing follow-up neuroimaging at yearly intervals in childhood to identify and prevent potential comorbidities.
PURPOSE: The most common neurological complications associated with tuberous sclerosis complex (TSC) include intractable seizures that begin in infancy and subependymal giant cell astrocytoma (SEGA) complicated by hydrocephalus with increasing age. Information on SEGA growth of TSC patients is limited. This study aimed to examine the TSC-SEGA growth rates by periodic neuroimaging. METHODS: This study evaluated the TSC-SEGA growth rates by serial neuroimaging. Fifty-eight patients with TSC underwent systematic evaluation, including a review of medical history and serial brain neuroimaging. RESULTS: While magnetic resonance imaging was more sensitive in detecting cortical tubers than computed tomography (73.1 vs. 0 %, p < 0.001), its efficacy in identifying intracranial lesions was comparable to that of computed tomography (96.2 vs. 100 %, p = 0.658). Significant tumor growth was observed in children (p = 0.012) and adults (p = 0.028) during follow-up periods, respectively (median for children 23.5 months, interquartile range 18-40 months and median for adults 23 months, interquartile range 12-34 months). Further, the SEGA growth rate in children was significantly higher than that in adults (75.6 vs. 16.5 %, p = 0.03). CONCLUSIONS: The results of the study show that SEGA has a significantly higher growth rate in children using serial follow-up brain imaging, suggesting the importance of performing follow-up neuroimaging at yearly intervals in childhood to identify and prevent potential comorbidities.
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Authors: Anna C Jansen; Elena Belousova; Mirjana P Benedik; Tom Carter; Vincent Cottin; Paolo Curatolo; Lisa D'Amato; Guillaume Beaure d'Augères; Petrus J de Vries; José C Ferreira; Martha Feucht; Carla Fladrowski; Christoph Hertzberg; Sergiusz Jozwiak; John A Lawson; Alfons Macaya; Ruben Marques; Rima Nabbout; Finbar O'Callaghan; Jiong Qin; Valentin Sander; Matthias Sauter; Seema Shah; Yukitoshi Takahashi; Renaud Touraine; Sotiris Youroukos; Bernard Zonnenberg; John C Kingswood Journal: Front Neurol Date: 2019-08-02 Impact factor: 4.003