Giovanni Morana1, Cesar Augusto Alves2, Domenico Tortora3, Jonathan L Finlay4, Mariasavina Severino3, Paolo Nozza5, Marcello Ravegnani6, Marco Pavanello6, Claudia Milanaccio7, Mohamad Maghnie8, Andrea Rossi3, Maria Luisa Garrè7. 1. Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy. giovannimorana@gaslini.org. 2. Radiology Department, Hospital Das Clinicas, Sao Paulo, Brazil. 3. Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy. 4. Division of Hematology, Oncology and BMT, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA. 5. Pathology Unit, Istituto Giannina Gaslini, Genoa, Italy. 6. Neurosurgery Unit, Istituto Giannina Gaslini, Genoa, Italy. 7. Neuro-oncology Unit, Istituto Giannina Gaslini, Genoa, Italy. 8. Pediatric Endocrine Unit, Istituto Giannina Gaslini, University of Genova, Genoa, Italy.
Abstract
PURPOSE: The role of T2*-based MR imaging in intracranial germ cell tumors (GCTs) has not been fully elucidated. The aim of this study was to evaluate the susceptibility-weighted imaging (SWI) or T2* gradient echo (GRE) features of germinomas and non-germinomatous germ cell tumors (NGGCTs) in midline and off-midline locations. METHODS: We retrospectively evaluated all consecutive pediatric patients referred to our institution between 2005 and 2016, for newly diagnosed, treatment-naïve intracranial GCT, who underwent MRI, including T2*-based MR imaging (T2* GRE sequences or SWI). Standard pre- and post-contrast T1- and T2-weighted imaging characteristics along with T2*-based MR imaging features of all lesions were evaluated. Diagnosis was performed in accordance with the SIOP CNS GCT protocol criteria. RESULTS: Twenty-four subjects met the inclusion criteria (17 males and 7 females). There were 17 patients with germinomas, including 5 basal ganglia primaries, and 7 patients with secreting NGGCT. All off-midline germinomas presented with SWI or GRE hypointensity; among midline GCT, all NGGCTs showed SWI or GRE hypointensity whereas all but one pure germinoma were isointense or hyperintense to normal parenchyma. A significant difference emerged on T2*-based MR imaging among midline germinomas, NGGCTs, and off-midline germinomas (p < 0.001). CONCLUSION: Assessment of the SWI or GRE characteristics of intracranial GCT may potentially assist in differentiating pure germinomas from NGGCT and in the characterization of basal ganglia involvement. T2*-based MR imaging is recommended in case of suspected intracranial GCT.
PURPOSE: The role of T2*-based MR imaging in intracranial germ cell tumors (GCTs) has not been fully elucidated. The aim of this study was to evaluate the susceptibility-weighted imaging (SWI) or T2* gradient echo (GRE) features of germinomas and non-germinomatous germ cell tumors (NGGCTs) in midline and off-midline locations. METHODS: We retrospectively evaluated all consecutive pediatric patients referred to our institution between 2005 and 2016, for newly diagnosed, treatment-naïve intracranial GCT, who underwent MRI, including T2*-based MR imaging (T2* GRE sequences or SWI). Standard pre- and post-contrast T1- and T2-weighted imaging characteristics along with T2*-based MR imaging features of all lesions were evaluated. Diagnosis was performed in accordance with the SIOP CNS GCT protocol criteria. RESULTS: Twenty-four subjects met the inclusion criteria (17 males and 7 females). There were 17 patients with germinomas, including 5 basal ganglia primaries, and 7 patients with secreting NGGCT. All off-midline germinomas presented with SWI or GRE hypointensity; among midline GCT, all NGGCTs showed SWI or GRE hypointensity whereas all but one pure germinoma were isointense or hyperintense to normal parenchyma. A significant difference emerged on T2*-based MR imaging among midline germinomas, NGGCTs, and off-midline germinomas (p < 0.001). CONCLUSION: Assessment of the SWI or GRE characteristics of intracranial GCT may potentially assist in differentiating pure germinomas from NGGCT and in the characterization of basal ganglia involvement. T2*-based MR imaging is recommended in case of suspected intracranial GCT.
Authors: Natascia Di Iorgi; Giovanni Morana; Flavia Napoli; Anna Elsa Maria Allegri; Andrea Rossi; Mohamad Maghnie Journal: Best Pract Res Clin Endocrinol Metab Date: 2015-05-09 Impact factor: 4.690
Authors: Emma A Lim; César A P F Alves; Stefania Picariello; Kristian Aquilina; Sotirios Bisdas; Ulrike Loebel; Kshitij Mankad; Felice D'Arco Journal: Childs Nerv Syst Date: 2021-09-16 Impact factor: 1.532
Authors: Didier Frappaz; Girish Dhall; Matthew J Murray; Stuart Goldman; Cecile Faure Conter; Jeffrey Allen; Rolf Dieter Kortmann; Daphne Haas-Kogen; Giovanni Morana; Jonathan Finlay; James C Nicholson; Ute Bartels; Mark Souweidane; Stefan Schönberger; Alexandre Vasiljevic; Patricia Robertson; Assunta Albanese; Claire Alapetite; Thomas Czech; Chin C Lau; Patrick Wen; David Schiff; Dennis Shaw; Gabriele Calaminus; Eric Bouffet Journal: Neuro Oncol Date: 2022-04-01 Impact factor: 13.029