Materiały źródłowe

• #1 Pediatric Brain Tumors

  https://braintumor.org/brain-tumors/about-brain-tumors/pediatric-brain-tumors/

  More than 5,200 children and adolescents (ages 0-19) will be diagnosed with a primary brain tumor in the U.S. this year alone. Whether benign (noncancerous) or malignant (cancerous), brain tumors can have lasting and life-altering physical, cognitive, social, and emotional impacts on a patients life. […] Pediatric brain tumors can differ from those in adults in terms of the specific types of tumors that are most common. […] There can be differences in the genetic and molecular characteristics of pediatric and adult brain tumors. Certain genetic mutations and markers may be more common in pediatric cases, influencing treatment options and responses. Treatment strategies for pediatric and adult brain tumors can vary due to differences in tumor biology, growth patterns, and the developing brain in children.

• #2 Brain Tumor Facts

  https://braintumor.org/brain-tumors/about-brain-tumors/brain-tumor-facts/

  Approximately 3,920 new cases of primary childhood brain tumors are expected to be diagnosed in 2023. […] Brain tumors are the most commonly diagnosed solid cancer in children ages 0-14 years, as well as the leading cause of childhood cancer-related death. […] The five-year relative survival rate for all primary childhood brain tumors is 83.1%. […] For primary malignant childhood tumors, the five-year relative survival rate is 75.6%. […] The five-year relative survival rate for all primary pediatric brain tumors (0-19) is 83.9%. […] For malignant tumors, the five-year relative survival rate is 75.6%. […] Pediatric brain tumors are the leading cause of cancer-related death among children and adolescents ages 0-19 years. […] AT/RT and high-grade gliomas have the lowest relative survival after diagnosis for patients 0-19 years with a brain tumor. […] Relative survival rates generally improve with increasing age at diagnosis in this population group, with poorest survival in those less than a year old at diagnosis.

• #3 MRI-based diagnosis and treatment of pediatric brain tumors: is tissue sample always needed?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8084800/

  Traditional management of newly diagnosed pediatric brain tumors (PBTs) consists of cranial imaging, typically magnetic resonance imaging (MRI), and is frequently followed by tissue diagnosis, through either surgical biopsy or tumor resection. […] Current management of newly diagnosed pediatric brain tumors (PBTs) consists of central nervous system (CNS) imaging, typically magnetic resonance imaging (MRI), followed by tissue diagnosis, through either surgical biopsy or tumor resection. […] The aim of this review is to explore the role of MRI-based diagnosis and treatment of these PBTs in the current oncological era. […] Typical MRI findings and indications for surgical biopsy of these lesions are described. […] The standard treatment for DIPG, to date, remains focal radiation therapy to the pons; no surgical or chemotherapeutic strategy has shown improvement in overall survival.

• #4 Brain Tumors – AANS

  https://www.aans.org/patients/conditions-treatments/brain-tumors/

  Brain tumors in children typically come from different tissues than those affecting adults. Treatments that are fairly well-tolerated by the adult brain (such as radiation therapy) may prevent normal development of a child’s brain, especially in children younger than age five. […] According to the Pediatric Brain Tumor Foundation, approximately 4,200 children are diagnosed with a brain tumor in the U.S. Seventy-two percent of children diagnosed with a brain tumor are younger than age 15. Most of these brain tumors grow in the posterior fossa (or back) of the brain. Children often present with hydrocephalus (fluid build up in the brain) or the face or body not working properly. […] Some types of brain tumors are more common in children than in adults. The most common types of pediatric tumors are medulloblastomas, low-grade astrocytomas (pilocytic), ependymomas, craniopharyngiomas and brainstem gliomas.

• #5 Brain Tumors in Children – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=brain-tumors-in-children-90-P02745

  Brain tumors can occur at any age. Brain tumors that occur in infants and children are very different from adult brain tumors, both in terms of the type of cells and the responsiveness to treatment. […] In addition, both the American Academy of Pediatrics and the National Cancer Institute recommend that children receive cancer diagnosis and treatment at one of the more than 200 medical centers in the U.S. that specialize in pediatric cancers. The organizations cite research studies that show 20% to 40% higher survival rates when children receive care in such specialized centers. […] In addition to a complete medical history and physical examination of your child, examination procedures for a brain tumor may include: […] Examination of a brain tumor depends mostly on the types of cells in which the tumor begins and the tumor location. […] Specific treatment for brain tumors will be determined by your child’s doctor based on: […] Continuous follow-up care is essential for a child diagnosed with a brain tumor.

• #6 Improving diagnosis of pediatric central nervous system tumours: aiming for early detection

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5367991/

  Central nervous system (CNS) tumours account for a quarter of all cancers in children aged 1 to 19 years, despite being relatively uncommon. Survival in many cases is poor, and thus the diagnosis may be devastating. Yet for 70% of children with CNS tumours, there is potential for effective treatment with multimodal therapy by a specialized, multidisciplinary team. Early detection is essential to allow the best possible treatment by an experienced team of pediatric neurosurgeons and oncologists, to optimize outcomes. However, CNS tumours in children are often initially misdiagnosed as more common pediatric conditions, such as migraine, gastroenteritis, or psychologic or behavioural problems. […] The diagnosis of CNS tumours necessitates a comprehensive clinical history and complete examination, in addition to advanced imaging, such as computed tomography (CT) or magnetic resonance imaging (MRI) to confirm clinical suspicion.

• #7 Pediatric Brain Tumor Symptoms & Diagnosis | Baptist Health Miami Cancer Institute

  https://baptisthealth.net/services/cancer-care/miami-cancer-institute/our-approach/pediatric-cancers/brain-tumors/symptoms-and-diagnosis

  Each child experiences symptoms differently. The size and location of a tumor also affect symptoms. Among the most common symptoms are: […] To diagnose and better analyze your child’s condition and help determine the best treatment your child’s doctor will complete a thorough medical history and order a number of tests. Depending on the type of brain tumor suspected, your child’s tests may include: […] A neurological exam, testing reflexes, muscle strength, eye and mouth movement, coordination and alertness. […] Computed tomography (CT or CAT) scans. […] Magnetic resonance imaging (MRI). […] X-rays. […] An angiogram, using dye and X-rays to view the blood vessels in the brain. […] A myelogram, an X-ray of the spine that is similar to an angiogram. […] Lumbar puncture or spinal tap. […] Positron emission tomography (PET) scan, a nuclear medicine procedure that measures the metabolic activity of cells.

• #8 Brain Tumors in Children | CureSearch

  https://curesearch.org/brain-tumors-in-children

  Typical symptoms of Central Nervous System (CNS) tumors are directly related to the location of the tumor, how fast it is growing and any associated tissue swelling that occurs in conjunction with the tumor. […] Parents often are the first to notice symptoms related to the development of a CNS tumor. […] Occasionally, the child’s teacher or physician may note signs and symptoms that are worrisome. […] Typical symptoms of CNS tumors include: Headaches (frequent, recurrent), especially after waking up in the morning; Vomiting, especially in the morning; Eye movement problems and/or vision changes; Unsteady gait or worsening balance; Weakness of one side of the face; Loss of previously acquired developmental milestones; Weakness in the arms or legs; Bulging fontanel (soft spot on an infant’s head where the bones that make up the skull have not fully joined) or increased head size in infants; Tilting of the head or neck to one side; Seizures; Difficulty with speech, swallowing or drooling; Back or neck pain, often waking the child at night.

• #9 Pediatric Brain Tumors | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/pediatric-brain-tumors

  The symptoms of a pediatric brain tumor vary according to the size, type, and location of the tumor. Symptoms may occur when a tumor presses on a nerve or damages certain parts of the brain. They may also occur when the brain swells or there is fluid buildup in the skull. The most common symptoms include: […] After taking a complete medical history and doing a physical examination of your child, we may use the following diagnostic tests to determine if a brain tumor is present: […] Neurological exam. Your child’s physician will test reflexes, muscle strength, eye and mouth movement, coordination and alertness. […] Computerized tomography scan (CAT scan or CT scan). This imaging procedure uses a combination of X-rays and computer technology to produce cross-sectional images (called 'slices’) both horizontal and vertical of the bones, muscles, fat and organs.

• #10 Brain Tumors in Children: Symptoms, Diagnosis and Treatment at Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/brain-tumors

  Approximately 4,000 children and adolescents in the U.S. are diagnosed with primary brain tumors each year. […] In addition to a complete medical history and physical examination of your child, examination procedures for a brain tumor may include: […] Neurological exam – your child’s physician tests reflexes, muscle strength, eye and mouth movement, coordination, and alertness. […] Computed tomography scan (also called a CT or CAT scan) – a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. […] Magnetic resonance imaging (MRI) – a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

• #11 Pediatric Brain Tumor | PM&R KnowledgeNow

  https://now.aapmr.org/pediatric-brain-tumor/

  Initial presentation depends on the site of tumor origin and developmental level of the affected child. Initial features are typically nonspecific. Infants and young children may present with irritability, failure to thrive, and developmental delay. Older children may present with fatigue, personality changes, headaches, and declining academic performance. More significant signs and symptoms may include ataxia, hemiparesis, cranial nerve palsy, hyperreflexia, papilledema, seizures, visual or speech disturbances, lethargy, and vomiting. Supratentorial tumors typically manifest with seizures or symptoms related to increased intracranial pressure. Meanwhile, posterior fossa tumors are often associated with headaches, nausea, vomiting, abnormal gait, and coordination difficulties. […] Brain biopsy is the current gold standard for diagnosing brain tumors that are unresectable and may be required for definitive diagnosis and treatment planning.

• #12 Brain Tumors in Children: Symptoms, Diagnosis and Treatment at Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/brain-tumors

  Approximately 4,000 children and adolescents in the U.S. are diagnosed with primary brain tumors each year. […] In addition to a complete medical history and physical examination of your child, examination procedures for a brain tumor may include: […] Neurological exam – your child’s physician tests reflexes, muscle strength, eye and mouth movement, coordination, and alertness. […] Computed tomography scan (also called a CT or CAT scan) – a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. […] Magnetic resonance imaging (MRI) – a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

• #13 Childhood brain tumours | The Brain Tumour Charity

  https://www.thebraintumourcharity.org/brain-tumour-signs-symptoms/childhood-brain-tumours/

  Opticians can also help diagnose childhood brain tumours. If a tumour is causing increased pressure in the skull, this can sometimes be seen at the back of the eye during an eye test. If an optician sees this, they will refer your child to a specialist eye doctor called an ophthalmologist. They may refer onto the other specialists, or directly for a scan.

• #14 Advanced Neuroimaging Approaches to Pediatric Brain Tumors

  https://www.mdpi.com/2072-6694/14/14/3401

  After leukemias, brain tumors are the most common cancers in children, and early, accurate diagnosis is critical to improve patient outcomes. […] Neuroimaging is key in the initial diagnosis and monitoring of pediatric brain tumors. Conventional anatomic imaging approaches (computed tomography (CT) and magnetic resonance imaging (MRI)) are useful for tumor detection but have limited utility differentiating tumor types and grades. Advanced MRI techniques (diffusion-weighed imaging, diffusion tensor imaging, functional MRI, arterial spin labeling perfusion imaging, MR spectroscopy, and MR elastography) provide additional and improved structural and functional information. […] Neuroimaging plays an invaluable role in the diagnosis, treatment, and monitoring of pediatric brain tumors. […] The incorporation of various advanced neuroimaging strategies, such as magnetic resonance spectroscopy (MRS) and perfusion-weighted imaging (PWI) has led to improved diagnostic accuracy in differentiating tumor recurrence from treatment-induced changes.

• #15 Tests for Brain and Spinal Cord Tumors in Children | American Cancer Society

  https://www.cancer.org/cancer/types/brain-spinal-cord-tumors-children/detection-diagnosis-staging/how-diagnosed.html

  Brain and spinal cord tumors are usually found because of signs or symptoms a child is having. If a tumor is suspected, tests will be needed to confirm the diagnosis. […] If your child has symptoms that suggest a brain or spinal cord tumor, the doctor will get a complete medical history, focusing on the symptoms and when they began. The doctor will also do a neurologic exam to check your child’s brain and spinal cord function, if possible. […] Your child’s doctors may order one or more imaging tests. These tests use x-rays, strong magnets, or radioactive substances to create pictures of internal organs such as the brain and spinal cord. […] Magnetic resonance imaging (MRI) and computed tomography (CT) scans are used most often for brain diseases. These scans will almost always show a brain or spinal cord tumor, if one is present.

• #16 MR Imaging of Pediatric Brain Tumors

  https://www.mdpi.com/2075-4418/12/4/961

  Primary brain tumors are the most common solid neoplasms in children and a leading cause of mortality in this population. MRI plays a central role in the diagnosis, characterization, treatment planning, and disease surveillance of intracranial tumors. […] Imaging plays a central role in the diagnosis, characterization, treatment planning, and disease surveillance of intracranial tumors. Magnetic resonance imaging (MRI) is the mainstay of neuroimaging and provides anatomical details, as well as cellular, vascular, and functional information for brain tumors. […] The purpose of this review is to provide an overview of imaging methodology, including conventional and advanced MRI techniques, and illustrate the MRI appearances of common pediatric brain tumors. […] MRI can be performed on a 1.5 or a 3 Tesla scanner; however, a 3 Tesla scanner has the advantages of better signal-to-noise ratio and faster imaging.

• #17 Brain Tumor Institute – Brain Tumor Diagnosis | Children’s National Hospital

  https://www.childrensnational.org/get-care/departments/brain-tumor-institute-neurooncology-program/brain-tumor-diagnosis

  MRI uses a magnetic field and pulses of radio wave energy to produce detailed images of your childs brain. Our wide-bore 3 Tesla MRI Scanner has a large opening. This can prevent your child from feeling afraid of being in a tight space (claustrophobic). […] This test uses trace amounts of radioactive substance to examine tumors at the molecular level. A PET scan can often detect abnormalities in cell activity before changes in their brain structures are visible. […] This test uses a combination of X-rays and computer technology to produce horizontal and vertical image slices of your childs brain. […] After surgically removing a tissue sample from your childs tumor, a neuro-pathologist with expertise in brain cancer examines it under a microscope. This helps us know the type and grade of cancer your child has.

• #18 MR Imaging of Pediatric Brain Tumors

  https://www.mdpi.com/2075-4418/12/4/961

  The use of gadolinium contrast material is standard for tumor imaging, although there may be some exceptions. […] The Response Assessment in Pediatric Neuro-Oncology (RAPNO) working groups have published guidelines for minimum essential MRI sequences for different types of pediatric brain tumors, and the reader is referred to those detailed recommendations. […] Diffusion-weighted images measure the mobility of water molecules, which in turn depends on the complexity of cytoarchitecture. […] Advanced imaging techniques may provide microstructural, hemodynamic, and metabolic information, and can be performed at most centers, although they do require additional imaging time and post-processing capabilities. […] Post-operative imaging is essential to evaluate the extent of surgical resection, to identify any immediate post-operative complications, and as a baseline for assessing the response to radiation and chemotherapy.

• #19 Brain Tumors – Seattle Children’s

  https://www.seattlechildrens.org/conditions/brain-tumors/

  Seattle Childrens has experts who precisely diagnose your childs tumor using a technique called molecular profiling and provide the best treatment. Few centers across the country have the expertise of our precision medicine team. […] This integrated molecular diagnosis testing may give information about the genetic changes in the tumor, which helps your care team confirm the tumor subtype and personalize treatment for your child. Our team is helping create international standards for integrated molecular diagnosis for children with brain tumors. […] As part of the diagnosis, we will take pictures (imaging studies) of the inside of your childs head or spine using: CT (computed tomography) scan, MRI (magnetic resonance imaging) scan of the whole brain and spine. […] If we find a tumor, we often need to do surgery to learn more about the type of tumor it is. The surgeon may do a biopsy or may remove the entire tumor and other nearby tissue. We use a microscope to look at the tumor cells and tissue and learn more about it.

• #20 Tests for Brain and Spinal Cord Tumors in Children | American Cancer Society

  https://www.cancer.org/cancer/types/brain-spinal-cord-tumors-children/detection-diagnosis-staging/how-diagnosed.html

  Brain and spinal cord tumors are usually found because of signs or symptoms a child is having. If a tumor is suspected, tests will be needed to confirm the diagnosis. […] If your child has symptoms that suggest a brain or spinal cord tumor, the doctor will get a complete medical history, focusing on the symptoms and when they began. The doctor will also do a neurologic exam to check your child’s brain and spinal cord function, if possible. […] Your child’s doctors may order one or more imaging tests. These tests use x-rays, strong magnets, or radioactive substances to create pictures of internal organs such as the brain and spinal cord. […] Magnetic resonance imaging (MRI) and computed tomography (CT) scans are used most often for brain diseases. These scans will almost always show a brain or spinal cord tumor, if one is present.

• #21 Tests to diagnose a children’s brain tumour

  https://www.cancerresearchuk.org/about-cancer/childrens-cancer/brain-tumours/tests

  CT stands for computed tomography. A CT scan uses x-rays and a computer to create detailed pictures of the inside of your body. It can help doctors find out if there is a tumour and where it is. […] Blood tests can check your child’s general health, including how well their liver and kidneys are working. If your child’s doctor thinks they might have a secreting germ cell tumour, they’ll have blood tests to check for certain hormone levels. These are known as tumour markers. […] Your child’s doctor might want to take a sample of the tumour (biopsy) seen on a scan. A pathologist looks at the cells down a microscope to find out exactly what type of brain tumour it is. This is so they can be sure what treatment is best. […] Your doctor may arrange tests to look for gene changes in the sample of your child’s brain tumour. They call these changes biomarkers. This can help them get more information about the type of brain tumour, work out how quickly the brain tumour might grow, work out how likely the brain tumour will respond to treatment. […] A lumbar puncture is a test to check the fluid that circulates round the brain and spinal cord. This is called cerebrospinal fluid or CSF. A lumbar puncture can check for cancer cells or for infection in the CSF.

• #22 Pediatric Brain Tumors | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/pediatric-brain-tumors

  The symptoms of a pediatric brain tumor vary according to the size, type, and location of the tumor. Symptoms may occur when a tumor presses on a nerve or damages certain parts of the brain. They may also occur when the brain swells or there is fluid buildup in the skull. The most common symptoms include: […] After taking a complete medical history and doing a physical examination of your child, we may use the following diagnostic tests to determine if a brain tumor is present: […] Neurological exam. Your child’s physician will test reflexes, muscle strength, eye and mouth movement, coordination and alertness. […] Computerized tomography scan (CAT scan or CT scan). This imaging procedure uses a combination of X-rays and computer technology to produce cross-sectional images (called 'slices’) both horizontal and vertical of the bones, muscles, fat and organs.

• #23 Brain Tumors in Children: Symptoms, Diagnosis and Treatment at Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/brain-tumors

  Approximately 4,000 children and adolescents in the U.S. are diagnosed with primary brain tumors each year. […] In addition to a complete medical history and physical examination of your child, examination procedures for a brain tumor may include: […] Neurological exam – your child’s physician tests reflexes, muscle strength, eye and mouth movement, coordination, and alertness. […] Computed tomography scan (also called a CT or CAT scan) – a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. […] Magnetic resonance imaging (MRI) – a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

• #24 MR Imaging of Pediatric Brain Tumors

  https://www.mdpi.com/2075-4418/12/4/961

  Primary brain tumors are the most common solid neoplasms in children and a leading cause of mortality in this population. MRI plays a central role in the diagnosis, characterization, treatment planning, and disease surveillance of intracranial tumors. […] Imaging plays a central role in the diagnosis, characterization, treatment planning, and disease surveillance of intracranial tumors. Magnetic resonance imaging (MRI) is the mainstay of neuroimaging and provides anatomical details, as well as cellular, vascular, and functional information for brain tumors. […] The purpose of this review is to provide an overview of imaging methodology, including conventional and advanced MRI techniques, and illustrate the MRI appearances of common pediatric brain tumors. […] MRI can be performed on a 1.5 or a 3 Tesla scanner; however, a 3 Tesla scanner has the advantages of better signal-to-noise ratio and faster imaging.

• #25 Pediatric Brain Tumor Symptoms & Diagnosis | Baptist Health Miami Cancer Institute

  https://baptisthealth.net/services/cancer-care/miami-cancer-institute/our-approach/pediatric-cancers/brain-tumors/symptoms-and-diagnosis

  Each child experiences symptoms differently. The size and location of a tumor also affect symptoms. Among the most common symptoms are: […] To diagnose and better analyze your child’s condition and help determine the best treatment your child’s doctor will complete a thorough medical history and order a number of tests. Depending on the type of brain tumor suspected, your child’s tests may include: […] A neurological exam, testing reflexes, muscle strength, eye and mouth movement, coordination and alertness. […] Computed tomography (CT or CAT) scans. […] Magnetic resonance imaging (MRI). […] X-rays. […] An angiogram, using dye and X-rays to view the blood vessels in the brain. […] A myelogram, an X-ray of the spine that is similar to an angiogram. […] Lumbar puncture or spinal tap. […] Positron emission tomography (PET) scan, a nuclear medicine procedure that measures the metabolic activity of cells.

• #26 Diagnosis of childhood brain and spinal cord tumours | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/brain-and-spinal-cord-childhood/diagnosis

  An MRI is considered the best way to look at tumours in the brain and spinal cord areas. It usually provides more detailed images of soft tissue than CT scans. […] CT scans are often the first imaging test done to see if there is an abnormality in the brain. If an abnormality is found, an MRI is done. […] A PET scan is used to see if abnormal areas seen on an MRI or a CT scan are likely to be cancerous. It may also be used after treatment to see if an abnormal area is a tumour or scar tissue. […] During a biopsy, the doctor removes tissues or cells from the body so they can be tested in a lab. The report from a pathologist will confirm whether or not cancer cells are found in the sample. […] Tumour marker tests can also be used to check a childs response to cancer treatment, but they can also be used to help diagnose certain types of brain and spinal cord tumours.

• #27 Brain Tumor Institute – Brain Tumor Diagnosis | Children’s National Hospital

  https://www.childrensnational.org/get-care/departments/brain-tumor-institute-neurooncology-program/brain-tumor-diagnosis

  MRI uses a magnetic field and pulses of radio wave energy to produce detailed images of your childs brain. Our wide-bore 3 Tesla MRI Scanner has a large opening. This can prevent your child from feeling afraid of being in a tight space (claustrophobic). […] This test uses trace amounts of radioactive substance to examine tumors at the molecular level. A PET scan can often detect abnormalities in cell activity before changes in their brain structures are visible. […] This test uses a combination of X-rays and computer technology to produce horizontal and vertical image slices of your childs brain. […] After surgically removing a tissue sample from your childs tumor, a neuro-pathologist with expertise in brain cancer examines it under a microscope. This helps us know the type and grade of cancer your child has.

• #28 Child Brain Tumors can be Classified by Advanced Imaging and AI | Imaging Technology News

  https://www.itnonline.com/content/child-brain-tumors-can-be-classified-advanced-imaging-and-ai

  Being able to classify a brain tumor’s type, without the use of biopsy, is hard to do; however diffusion weighted imaging, an advanced imaging technique, when combined with machine learning, can help, a study has found […] February 17, 2021 Diffusion weighted imaging and machine learning can successfully classify the diagnosis and characteristics of common types of pediatric brain tumors a UK-based multi-center study, including WMG at the University of Warwick has found. This means that the tumour can be characterised and treated more efficiently. […] Currently a qualitative assessment of magnetic resonance imaging (MRI) by radiologists is used, however overlapping radiological characteristics can make it difficult to distinguish which type of tumor it is, without the confirmation of biopsy.

• #29 Combining multi-site magnetic resonance imaging with machine learning predicts survival in pediatric brain tumors | Scientific Reports

  https://www.nature.com/articles/s41598-021-96189-8

  Brain tumors represent the highest cause of mortality in the pediatric oncological population. Diagnosis is commonly performed with magnetic resonance imaging. Survival biomarkers are challenging to identify due to the relatively low numbers of individual tumor types. […] Medical imaging is an important diagnostic aid for brain tumors, since it is non-invasive and can include the whole tumor and surrounding tissue. It is also capable of probing the tumor microenvironment in vivo, improving our understanding of the in vivo neovascularization and cellularity of the tumor, as well as surrounding cerebral tissue through perfusion and diffusion imaging, respectively. […] Diffusion imaging is available on every major commercial MRI scanner and is routinely used to assess brain tumors. Apparent diffusion coefficient (ADC) maps represent the speed of water motion in the tissue and this correlated cellularity. Perfusion imaging is often acquired either with dynamic susceptibility contrast (DSC) or arterial spin labelling (ASL) techniques.

• #30 Frontiers | Pediatric brain tumors: A neuropathologist’s approach to the integrated diagnosis

  https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1143363/full

  Pediatric CNS tumors, in particular, rely heavily on the integration of molecular data with histologic, clinical, and radiographic features to reach the most accurate diagnosis. […] The integrated diagnosis was designed to incorporate multiple critical data types (i.e., tumor type, relevant molecular information, and tumor grade) into a single, line diagnosis. […] Histologic diagnosis and grading are typically based on analysis of H&E stained sections often in conjunction with ancillary immunohistochemical stains. […] Molecular testing is a key component to the integrated diagnosis and overall characterization of many CNS tumors. […] Even with the many advances in imaging techniques, histologic examination is still considered to be the gold standard for CNS tumor diagnosis. […] The diagnosis of CNS tumors should take into account the tumor location. […] The formulation of an integrated diagnosis should take into account all pertinent clinical, radiographic, histologic, immunohistochemical, and molecular information. […] The integrated diagnosis has become central to the WHO classification of CNS tumors.

• #31 Childhood Brain Tumor Diagnosis | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/childhood-brain-tumors/childhood-brain-tumor-diagnosis.html

  Early and accurate diagnosis of a childhood brain tumor can increase the chances for successful treatment. […] If your child has symptoms of a brain tumor, the doctor will examine your child carefully and ask you questions about your childs and familys medical history. […] One or more diagnostic test may be used to find out if your child has a brain tumor and if it has spread. These tests also may be used to find out if treatment is working. […] If imaging tests show an area that may be a brain tumor, a biopsy almost always is necessary for diagnosis. […] A biopsy may be done during surgery in which all or part of the brain tumor is removed. […] If a tumor is difficult to reach, a CT scan may be used for to place a hollow needle inside the tumor and remove a small amount of tissue. […] A small amount of CSF (cerebrospinal fluid, which is the clear liquid in and around the brain and spine) is removed with a needle and looked at with a microscope.

• #32 Brain Tumors: Diagnosis

  https://healthlibrary.tanner.org/Library/DiseasesConditions/Pediatric/HighRiskNewborn/34,BBraD2

  A craniotomy might be done to do a brain tumor biopsy. During this surgery, a healthcare provider opens the skull to take out as much of the tumor as possible. This tissue is then sent to a lab and tested to see if it’s cancer. If the tumor is in a place that makes it hard to remove, another type of biopsy, called a stereotactic biopsy, might be done. For this biopsy, the neurosurgeon drills a small hole in the skull and puts a hollow needle into the brain to take out a small piece of the tumor. The needle is carefully guided to the tumor with the help of an imaging test, like an MRI or CT scan. […] When your healthcare provider has the results of your tests, they will contact you. Your provider will talk with you about other tests you may need if a brain tumor is found. Make sure you understand the results and what your next steps should be.

• #33 MRI-based diagnosis and treatment of pediatric brain tumors: is tissue sample always needed?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8084800/

  Imaging features supportive of DIPG, in accordance with typical clinical symptoms, are considered sufficient for diagnosing DIPG and initiating empirical treatment. […] The diagnosis of DIPG based on radiological and clinical features is considered by most to be sufficient, and the current standard of care. […] The diagnosis of OPG is based on pathognomonic MRI findings, in combination with the diagnosis of NF1 and noticeable changes on eye exam. […] Therefore, surgical biopsy has practically no role in tumor diagnosis of OPG in NF1 children. […] However, biopsy is increasingly indicated once aggressive or transformed tumor behavior is suspected, focused not only on histologic confirmation of the tumor type and its histologic grade but also on genetic alterations, such as ATRX, CDKN2A, and TP53, suggestive of transformed or higher-grade tumors.

• #34

  https://link.springer.com/article/10.1007/s00381-021-05148-1

  Imaging features supportive of DIPG, in accordance with typical clinical symptoms, are considered sufficient for diagnosing DIPG and initiating empirical treatment. […] The diagnosis of DIPG based on radiological and clinical features is considered by most to be sufficient, and the current standard of care. […] Diagnosis of BTGs based on the typical MRI and MRS characteristics is sufficient. […] However, biopsy is increasingly indicated once aggressive or transformed tumor behavior is suspected, focused not only on histologic confirmation of the tumor type and its histologic grade but also on genetic alterations, such as ATRX, CDKN2A, and TP53, suggestive of transformed or higher-grade tumors. […] Pathognomonic MRI findings of OPG, in combination with the diagnosis of NF1 and noticeable changes on eye exam, lead to the diagnosis of OPG.

• #35 Pediatric Brain Tumor Types & Diagnosis | MSK Kids | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/pediatrics/cancer-care/types/pediatric-brain-tumors/diagnosis

  Memorial Sloan Kettering Cancer Centers Pediatric Brain Tumor team diagnose and treat children, adolescents, and young adults who have any type of brain tumor. […] Establishing the proper diagnosis is the crucial first step to ensure that your child receives the most appropriate treatment at Memorial Sloan Kettering. Once a child exhibits symptoms that may be caused by a brain tumor, imaging tests such as CT or MRI scans are performed. These tests help doctors see the extent of the tumor and plan for either the removal of the tumor or a biopsy. Doing this allows the doctors to know exactly what type of tumor they are treating. We also incorporate DNA methylation profiling, a diagnostic tool that significantly improves the accuracy of a diagnosis compared with standard methods alone. […] The diagnosis is suspected using CT or MRI scans and confirmed by a pathology examination after the tumors surgical removal. […] We offer our patients the most advanced genetic testing, including MSK-IMPACT and Archer FusionPlex. These tests allow us to find genetic mutations and other changes that can cause cancer. They can provide a lot of information thats important for diagnosis, prognosis, and treatment.

• #36 Frontiers | Pediatric brain tumors: A neuropathologist’s approach to the integrated diagnosis

  https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1143363/full

  Pediatric CNS tumors, in particular, rely heavily on the integration of molecular data with histologic, clinical, and radiographic features to reach the most accurate diagnosis. […] The integrated diagnosis was designed to incorporate multiple critical data types (i.e., tumor type, relevant molecular information, and tumor grade) into a single, line diagnosis. […] Histologic diagnosis and grading are typically based on analysis of H&E stained sections often in conjunction with ancillary immunohistochemical stains. […] Molecular testing is a key component to the integrated diagnosis and overall characterization of many CNS tumors. […] Even with the many advances in imaging techniques, histologic examination is still considered to be the gold standard for CNS tumor diagnosis. […] The diagnosis of CNS tumors should take into account the tumor location. […] The formulation of an integrated diagnosis should take into account all pertinent clinical, radiographic, histologic, immunohistochemical, and molecular information. […] The integrated diagnosis has become central to the WHO classification of CNS tumors.

• #37 Pediatric Brain Tumor Types & Diagnosis | MSK Kids | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/pediatrics/cancer-care/types/pediatric-brain-tumors/diagnosis

  Memorial Sloan Kettering Cancer Centers Pediatric Brain Tumor team diagnose and treat children, adolescents, and young adults who have any type of brain tumor. […] Establishing the proper diagnosis is the crucial first step to ensure that your child receives the most appropriate treatment at Memorial Sloan Kettering. Once a child exhibits symptoms that may be caused by a brain tumor, imaging tests such as CT or MRI scans are performed. These tests help doctors see the extent of the tumor and plan for either the removal of the tumor or a biopsy. Doing this allows the doctors to know exactly what type of tumor they are treating. We also incorporate DNA methylation profiling, a diagnostic tool that significantly improves the accuracy of a diagnosis compared with standard methods alone. […] The diagnosis is suspected using CT or MRI scans and confirmed by a pathology examination after the tumors surgical removal. […] We offer our patients the most advanced genetic testing, including MSK-IMPACT and Archer FusionPlex. These tests allow us to find genetic mutations and other changes that can cause cancer. They can provide a lot of information thats important for diagnosis, prognosis, and treatment.

• #38 Brain Tumor Institute – Brain Tumor Diagnosis | Children’s National Hospital

  https://www.childrensnational.org/get-care/departments/brain-tumor-institute-neurooncology-program/brain-tumor-diagnosis

  Tools such as the NanoString Digital Molecular Barcoding System allow us to examine the unique molecular characteristics of your childs tumor. This helps us tailor brain tumor treatments to meet their specific needs. […] Our team represents some of the nations top minds in pediatric brain tumor care. From neuro-radiology to neuro-pathology, we offer a level of specialization found only in the countrys top programs. […] We offer the complete range of diagnostic tests. In most cases, we start with a neurologic exam. During this test, we ask your child questions and have them perform simple tasks to assess their mental status and brain functioning. This helps us determine whether your child needs additional testing, and if so, which ones would be most helpful. […] We use the best available imaging technology. This allows for faster scans while generating high quality, detailed images.

• #39 How We Diagnose Brain Tumors | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/types/brain-tumors/diagnosis

  Brain tumors are categorized or graded on a scale of I to IV, with I being low-grade (slow-growing) and IV being high-grade (rapidly growing). […] At the Dana-Farber Brigham Cancer Center’s Center for Neuro-Oncology, we approach cancer diagnosis through precision cancer medicine, which characterizes the genetic and molecular abnormalities in each specific brain tumor. […] Each of our neuropathologists specializes in the research of a specific brain tumor type, providing you with the most expert approach to the diagnosis of your brain tumor. […] All patients’ brain tumor tissue not only undergoes the standard pathology exams to provide a precise diagnosis, but also a number of pioneering tests and scans for mutated genes and misassembled chromosomes, as well as whole-genome searches for surplus or missing copies of genes. […] Such extensive multi-testing genetic profiling identifies the type and characteristics of a particular tumor, and is part of the standard diagnostic process at the Center for Neuro-Oncology.

• #40 Frontiers | Pediatric brain tumors: A neuropathologist’s approach to the integrated diagnosis

  https://www.frontiersin.org/articles/10.3389/fped.2023.1143363/full

  Pediatric CNS tumors, in particular, rely heavily on the integration of molecular data with histologic, clinical, and radiographic features to reach the most accurate diagnosis. […] The integrated diagnosis was designed to incorporate multiple critical data types (i.e., tumor type, relevant molecular information, and tumor grade) into a single, line diagnosis. […] Histologic assessment remains a critical component in the workup of CNS tumors. […] Molecular testing is a key component to the integrated diagnosis and overall characterization of many CNS tumors. […] Even with the many advances in imaging techniques, histologic examination is still considered to be the gold standard for CNS tumor diagnosis. […] The diagnosis of CNS tumors should take into account the tumor location. […] The formulation of an integrated diagnosis should take into account all pertinent clinical, radiographic, histologic, immunohistochemical, and molecular information. […] The integrated diagnosis has become central to the WHO classification of CNS tumors.

• #41 Diagnosis of childhood brain and spinal cord tumours | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/brain-and-spinal-cord-childhood/diagnosis

  An MRI is considered the best way to look at tumours in the brain and spinal cord areas. It usually provides more detailed images of soft tissue than CT scans. […] CT scans are often the first imaging test done to see if there is an abnormality in the brain. If an abnormality is found, an MRI is done. […] A PET scan is used to see if abnormal areas seen on an MRI or a CT scan are likely to be cancerous. It may also be used after treatment to see if an abnormal area is a tumour or scar tissue. […] During a biopsy, the doctor removes tissues or cells from the body so they can be tested in a lab. The report from a pathologist will confirm whether or not cancer cells are found in the sample. […] Tumour marker tests can also be used to check a childs response to cancer treatment, but they can also be used to help diagnose certain types of brain and spinal cord tumours.

• #42 Diagnosis of childhood brain and spinal cord tumours | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/brain-and-spinal-cord-childhood/diagnosis

  Doctors can use the following types of cell and tissue studies to help diagnose childhood brain and spinal cord tumours. […] A lumbar puncture removes a small amount of cerebrospinal fluid (CSF) from the spine to be examined under a microscope. It may be done as part of staging to see if a brain tumour has spread to the CSF. […] A complete blood count (CBC) measures the number and quality of white blood cells, red blood cells and platelets. A CBC is done to give the doctors a baseline that they can check against during treatment. […] Blood chemistry tests measure certain chemicals in the blood. They show how well certain organs are working and can help find problems. […] During an angiography, a contrast dye is injected into the bloodstream and x-rays are taken to map out the size and shape of blood vessels. It is used to look at the blood vessels and the flow of blood in the brain, which is helpful in planning surgery.

• #43 Pediatric Brain Tumors | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/pediatric-brain-tumors

  Magnetic resonance imaging (MRI). This imaging procedure uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs and structures within the body. […] X-ray. This imaging test uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs onto film. […] Bone scan. This imaging test takes X-rays of the bones after a dye has been injected that is absorbed by bone tissue. […] Angiogram. This imaging test uses a dye to visualize all the blood vessels in the brain to detect certain types of tumors. […] Lumbar puncture/spinal tap. For this procedure, a special needle is placed into the lower back and into the spinal canal around the spinal cord. A small amount of cerebrospinal fluid, which surrounds the brain and spinal cord, can be removed and sent for testing.

• #44 Tests for Brain and Spinal Cord Tumors in Children | American Cancer Society

  https://www.cancer.org/cancer/types/brain-spinal-cord-tumors-children/detection-diagnosis-staging/how-diagnosed.html

  MRI scans are very good for looking at the brain and spinal cord and are considered the best way to look for tumors in these areas. […] MRI scans can take a long time, and they require a person to stay still for several minutes at a time. […] Imaging tests such as MRI and CT scans may show that a child has a brain or spinal cord tumor. But often the type of tumor can only be determined by removing a sample of it, which is called a biopsy. […] The biopsy samples are then sent to a pathologist (a doctor specializing in diagnosis of diseases by lab tests). The pathologist looks at it under a microscope (and might do other lab tests) to determine if the tumor is benign or malignant (cancerous) and exactly what type of tumor it is. […] This test is used mainly to look for signs of cancer in the cerebrospinal fluid (CSF), which is the liquid that bathes the brain and spinal cord.

• #45 Tests to diagnose a children’s brain tumour

  https://www.cancerresearchuk.org/about-cancer/childrens-cancer/brain-tumours/tests

  CT stands for computed tomography. A CT scan uses x-rays and a computer to create detailed pictures of the inside of your body. It can help doctors find out if there is a tumour and where it is. […] Blood tests can check your child’s general health, including how well their liver and kidneys are working. If your child’s doctor thinks they might have a secreting germ cell tumour, they’ll have blood tests to check for certain hormone levels. These are known as tumour markers. […] Your child’s doctor might want to take a sample of the tumour (biopsy) seen on a scan. A pathologist looks at the cells down a microscope to find out exactly what type of brain tumour it is. This is so they can be sure what treatment is best. […] Your doctor may arrange tests to look for gene changes in the sample of your child’s brain tumour. They call these changes biomarkers. This can help them get more information about the type of brain tumour, work out how quickly the brain tumour might grow, work out how likely the brain tumour will respond to treatment. […] A lumbar puncture is a test to check the fluid that circulates round the brain and spinal cord. This is called cerebrospinal fluid or CSF. A lumbar puncture can check for cancer cells or for infection in the CSF.

• #46 Tests for Brain and Spinal Cord Tumors in Children | American Cancer Society

  https://www.cancer.org/cancer/types/brain-spinal-cord-tumors-children/detection-diagnosis-staging/how-diagnosed.html

  Because some tumors (especially medulloblastomas) can spread beyond the nervous system, in some instances the doctor may recommend looking at cells in your child’s bone marrow (the soft, inner part of certain bones) to see if tumor cells have spread there. […] These lab tests are rarely used to diagnose brain and spinal cord tumors, but if your child has been sick for some time they may be done to check how well the liver, kidneys, and some other organs are working.

• #47 Diagnosis of childhood brain and spinal cord tumours | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/brain-and-spinal-cord-childhood/diagnosis

  An MRI is considered the best way to look at tumours in the brain and spinal cord areas. It usually provides more detailed images of soft tissue than CT scans. […] CT scans are often the first imaging test done to see if there is an abnormality in the brain. If an abnormality is found, an MRI is done. […] A PET scan is used to see if abnormal areas seen on an MRI or a CT scan are likely to be cancerous. It may also be used after treatment to see if an abnormal area is a tumour or scar tissue. […] During a biopsy, the doctor removes tissues or cells from the body so they can be tested in a lab. The report from a pathologist will confirm whether or not cancer cells are found in the sample. […] Tumour marker tests can also be used to check a childs response to cancer treatment, but they can also be used to help diagnose certain types of brain and spinal cord tumours.

• #48 Diagnosis of childhood brain and spinal cord tumours | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/brain-and-spinal-cord-childhood/diagnosis

  Doctors can use the following types of cell and tissue studies to help diagnose childhood brain and spinal cord tumours. […] A lumbar puncture removes a small amount of cerebrospinal fluid (CSF) from the spine to be examined under a microscope. It may be done as part of staging to see if a brain tumour has spread to the CSF. […] A complete blood count (CBC) measures the number and quality of white blood cells, red blood cells and platelets. A CBC is done to give the doctors a baseline that they can check against during treatment. […] Blood chemistry tests measure certain chemicals in the blood. They show how well certain organs are working and can help find problems. […] During an angiography, a contrast dye is injected into the bloodstream and x-rays are taken to map out the size and shape of blood vessels. It is used to look at the blood vessels and the flow of blood in the brain, which is helpful in planning surgery.

• #49 Brain tumours in children | CCLG – The Children & Young People’s Cancer Association

  https://www.cclg.org.uk/about-cancer/cancer-children-and-young-people/types-cancer-children-and-young-people/brain-tumours-children

  A small operation is done (under anaesthetic) to remove a piece of the tumour. The sample is looked at in the laboratory to find out exactly what type of tumour it is. A biopsy isn’t always done as it is sometimes better to remove the whole tumour in one operation. […] These are useful as part of diagnosis and also for monitoring response to treatment. Tests will look at how well your child can see, including any double-vision, eye movements and blind spots. […] There are different types of brain tumours and they are usually named after the type of cells they develop from. The main types are astrocytoma, ependymoma, and medulloblastoma, but there are many other, less common types. […] Malignant primary brain tumours are most likely to cause problems by causing pressure and damage to the areas around them and by spreading to the normal brain tissue close by. Sometimes, they spread to other areas distant to the original tumour.

• #50 Childhood brain tumours | The Brain Tumour Charity

  https://www.thebraintumourcharity.org/brain-tumour-signs-symptoms/childhood-brain-tumours/

  Opticians can also help diagnose childhood brain tumours. If a tumour is causing increased pressure in the skull, this can sometimes be seen at the back of the eye during an eye test. If an optician sees this, they will refer your child to a specialist eye doctor called an ophthalmologist. They may refer onto the other specialists, or directly for a scan.

• #51 How We Diagnose Brain Tumors | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/types/brain-tumors/diagnosis

  Brain tumors are categorized or graded on a scale of I to IV, with I being low-grade (slow-growing) and IV being high-grade (rapidly growing). […] At the Dana-Farber Brigham Cancer Center’s Center for Neuro-Oncology, we approach cancer diagnosis through precision cancer medicine, which characterizes the genetic and molecular abnormalities in each specific brain tumor. […] Each of our neuropathologists specializes in the research of a specific brain tumor type, providing you with the most expert approach to the diagnosis of your brain tumor. […] All patients’ brain tumor tissue not only undergoes the standard pathology exams to provide a precise diagnosis, but also a number of pioneering tests and scans for mutated genes and misassembled chromosomes, as well as whole-genome searches for surplus or missing copies of genes. […] Such extensive multi-testing genetic profiling identifies the type and characteristics of a particular tumor, and is part of the standard diagnostic process at the Center for Neuro-Oncology.

• #52 Brain Tumor Institute – Brain Tumor Diagnosis | Children’s National Hospital

  https://www.childrensnational.org/get-care/departments/brain-tumor-institute-neurooncology-program/brain-tumor-diagnosis

  Tools such as the NanoString Digital Molecular Barcoding System allow us to examine the unique molecular characteristics of your childs tumor. This helps us tailor brain tumor treatments to meet their specific needs. […] Our team represents some of the nations top minds in pediatric brain tumor care. From neuro-radiology to neuro-pathology, we offer a level of specialization found only in the countrys top programs. […] We offer the complete range of diagnostic tests. In most cases, we start with a neurologic exam. During this test, we ask your child questions and have them perform simple tasks to assess their mental status and brain functioning. This helps us determine whether your child needs additional testing, and if so, which ones would be most helpful. […] We use the best available imaging technology. This allows for faster scans while generating high quality, detailed images.

• #53 Pediatric Brain Tumor Types & Diagnosis | MSK Kids | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/pediatrics/cancer-care/types/pediatric-brain-tumors/diagnosis

  Memorial Sloan Kettering Cancer Centers Pediatric Brain Tumor team diagnose and treat children, adolescents, and young adults who have any type of brain tumor. […] Establishing the proper diagnosis is the crucial first step to ensure that your child receives the most appropriate treatment at Memorial Sloan Kettering. Once a child exhibits symptoms that may be caused by a brain tumor, imaging tests such as CT or MRI scans are performed. These tests help doctors see the extent of the tumor and plan for either the removal of the tumor or a biopsy. Doing this allows the doctors to know exactly what type of tumor they are treating. We also incorporate DNA methylation profiling, a diagnostic tool that significantly improves the accuracy of a diagnosis compared with standard methods alone. […] The diagnosis is suspected using CT or MRI scans and confirmed by a pathology examination after the tumors surgical removal. […] We offer our patients the most advanced genetic testing, including MSK-IMPACT and Archer FusionPlex. These tests allow us to find genetic mutations and other changes that can cause cancer. They can provide a lot of information thats important for diagnosis, prognosis, and treatment.

• #54 At the Forefront of Pediatric Brain Tumor Therapy | Texas Children’s

  https://www.texaschildrens.org/content/for-physicians/forefront-pediatric-brain-tumor-therapy

  One of the advantages of a leading-edge Brain Tumor Program, like the one at Texas Children’s Hospital, is the ability to offer patients the expertise of outstanding pediatric subspecialists at every point on their journey. […] The Brain Tumor Program, led by co-Directors Murali Chintagumpala, MD, and Will Parsons, MD, PhD, is a multidisciplinary team comprised of pediatric-trained experts in cancer genetics and genomics, neuro-oncology, radiation oncology, neurology, neurosurgery, neuropathology, and neuropsychology, neuro-ophthalmology, physical therapy, endocrinology and more. […] “With advances in surgical and genomic technology, we can now safely determine the tumor’s molecular make-up, The goal of this molecular analysis is to more precisely diagnose the tumor so that we can tailor treatment recommendations to maximize their therapeutic potential, while simultaneously reducing treatment-related toxicities and the potential for treatment-related late effects,” Dr. Chintagumpala said.

• #55 Child Brain Tumors can be Classified by Advanced Imaging and AI | Imaging Technology News

  https://www.itnonline.com/content/child-brain-tumors-can-be-classified-advanced-imaging-and-ai

  Being able to classify a brain tumor’s type, without the use of biopsy, is hard to do; however diffusion weighted imaging, an advanced imaging technique, when combined with machine learning, can help, a study has found […] February 17, 2021 Diffusion weighted imaging and machine learning can successfully classify the diagnosis and characteristics of common types of pediatric brain tumors a UK-based multi-center study, including WMG at the University of Warwick has found. This means that the tumour can be characterised and treated more efficiently. […] Currently a qualitative assessment of magnetic resonance imaging (MRI) by radiologists is used, however overlapping radiological characteristics can make it difficult to distinguish which type of tumor it is, without the confirmation of biopsy.

• #56 Combining multi-site magnetic resonance imaging with machine learning predicts survival in pediatric brain tumors | Scientific Reports

  https://www.nature.com/articles/s41598-021-96189-8

  Studies have shown that diffusion and perfusion imaging are able to discriminate between pediatric tumor types in vivo, with high cellularity and perfusion in high grade tumors, and vice versa for low-grade. […] In this study we have therefore taken a novel approach to the understanding of risk and survival in pediatric brain tumors through combining diffusion and perfusion MRI and combining this with both supervised and unsupervised machine learning to determine key imaging derived risk factors and novel prognostic groups. […] Whole cohort univariate cox regression revealed a number of imaging features with significantly elevated hazard ratios (HR), for example Uncorrected CBV ROI mean (HR 3.1, Confidence Intervals (CI) 1.5-6.6, p=0.003). […] Using the Bayesian imaging features, k means clustering revealed two distinct clusters, which when combined with KaplanMeier analysis revealed a significant difference between a high and low risk population (p=0.0015).

• #57 Combining multi-site magnetic resonance imaging with machine learning predicts survival in pediatric brain tumors | Scientific Reports

  https://www.nature.com/articles/s41598-021-96189-8

  KaplanMeier analysis of high-grade tumors in the high and low risk clusters revealed a significant difference in survival (p<0.05) with a hazard ratio of 7. [...] This work has demonstrated a highly novel clinical application of advanced survival modelling and machine learning to non-invasively stratify patients according to risk. This provides a non-invasive, multi-modal MRI approach to determining the malignant nature of a tumor and its potential for poor prognosis. Both diffusion and perfusion were found to be important in determining risk, with perfusion contributing to a greater extent emphasizing the importance of acquiring perfusion imaging.

• #58 MRI and AI could significantly reduce pediatric brain tumor diagnosis time

  https://medicalxpress.com/news/2024-06-mri-ai-significantly-pediatric-brain.html

  MRI and AI could significantly reduce pediatric brain tumor diagnosis time […] Children with the most common malignant form of brain cancer could see diagnostic wait times reduced thanks to new research that trialed a new, quicker and less invasive way of determining which type of tumor they have. […] The collaborative team identified how the four different groups of medulloblastoma, a malignant children’s brain tumor, had a specific profile based on their individual metabolism. […] Taking cell samples from 86 tumors, a laboratory test was used to accurately identify metabolic markers including chemicals specific to the different tumor groups. […] Significantly, the research could pave the way for using MRI scanning combined with machine learning to assess medulloblastomas for their 'signature’ metabolic profiles without the need for invasive biopsy and could rapidly reduce the current 3-4 week wait from presentation to full diagnosis.

• #59 Child Brain Tumors can be Classified by Advanced Imaging and AI | Imaging Technology News

  https://www.itnonline.com/content/child-brain-tumors-can-be-classified-advanced-imaging-and-ai

  The study found that tumor diagnostic classification can be improved by using non-invasive diffusion weighted imaging, when combined with machine learning (AI). […] Values from the analysis of Apparent Diffusion Coeffcient maps from these images’ regions have been fed to AI algorithms to successfully discriminate the three most common types of pediatric posterior fossa brain tumours, non-invasively. […] Using AI and advance Magnetic Resonance imaging characteristics, such as Apparent Diffusion Coefficient (ADC) values from diffusion weighted images, can potentially help distinguish, in a non-invasive way, between the main three different types of pediatric tumours in the posterior fossa, the area of the brain where such tumours are most commonly found in children. […] If this advanced imaging technique, combined with AI technology, can be routinely enrolled into hospitals it means that childhood brain tumors can be characterised and classified more efficiently, and in turn means that treatments can be pursued in a quicker manner with favourable outcomes for children suffering from the disease. […] Here we have combined readily available scans with artificial intelligence to provide high levels of diagnostic accuracy that can start to give some answers.

• #60 MRI and AI could significantly reduce pediatric brain tumor diagnosis time

  https://medicalxpress.com/news/2024-06-mri-ai-significantly-pediatric-brain.html

  „Time is so important in cancer diagnosis so our findings on different types of medulloblastoma having a detectable signature metabolism could be game changing for quickly diagnosing, and then offering the best possible treatment for children.” […] „Providing a rapid diagnosis using innovative scanning and AI (artificial intelligence) techniques, has the potential to revolutionize patient management, allowing early non-invasive diagnosis, tailoring of treatment decisions and reducing the period of uncertainty for patients and parents while awaiting a full diagnosis.” […] „Developing quicker, less invasive ways to accurately diagnose the different types of medulloblastoma, the most common malignant brain tumor in children, is a crucial step in improving outcomes for young patients.” […] „This important study has identified a new way to distinguish between the four subgroups of medulloblastoma. This discovery paves the way for the development of simple imaging tests that could quickly and accurately diagnose the different types of medulloblastoma.”

• #61 Frontiers | Pediatric brain tumors: A neuropathologist’s approach to the integrated diagnosis

  https://www.frontiersin.org/articles/10.3389/fped.2023.1143363/full

  Pediatric CNS tumors, in particular, rely heavily on the integration of molecular data with histologic, clinical, and radiographic features to reach the most accurate diagnosis. […] The integrated diagnosis was designed to incorporate multiple critical data types (i.e., tumor type, relevant molecular information, and tumor grade) into a single, line diagnosis. […] Histologic assessment remains a critical component in the workup of CNS tumors. […] Molecular testing is a key component to the integrated diagnosis and overall characterization of many CNS tumors. […] Even with the many advances in imaging techniques, histologic examination is still considered to be the gold standard for CNS tumor diagnosis. […] The diagnosis of CNS tumors should take into account the tumor location. […] The formulation of an integrated diagnosis should take into account all pertinent clinical, radiographic, histologic, immunohistochemical, and molecular information. […] The integrated diagnosis has become central to the WHO classification of CNS tumors.

• #62 At the Forefront of Pediatric Brain Tumor Therapy | Texas Children’s

  https://www.texaschildrens.org/content/for-physicians/forefront-pediatric-brain-tumor-therapy

  One of the advantages of a leading-edge Brain Tumor Program, like the one at Texas Children’s Hospital, is the ability to offer patients the expertise of outstanding pediatric subspecialists at every point on their journey. […] The Brain Tumor Program, led by co-Directors Murali Chintagumpala, MD, and Will Parsons, MD, PhD, is a multidisciplinary team comprised of pediatric-trained experts in cancer genetics and genomics, neuro-oncology, radiation oncology, neurology, neurosurgery, neuropathology, and neuropsychology, neuro-ophthalmology, physical therapy, endocrinology and more. […] “With advances in surgical and genomic technology, we can now safely determine the tumor’s molecular make-up, The goal of this molecular analysis is to more precisely diagnose the tumor so that we can tailor treatment recommendations to maximize their therapeutic potential, while simultaneously reducing treatment-related toxicities and the potential for treatment-related late effects,” Dr. Chintagumpala said.

• #63 Brain Tumor Institute – Brain Tumor Diagnosis | Children’s National Hospital

  https://www.childrensnational.org/get-care/departments/brain-tumor-institute-neurooncology-program/brain-tumor-diagnosis

  Genetic testing helps us learn more about how inherited traits could affect your childs cancer risk. […] Our Diagnostic Imaging and Radiology team includes expert physicians, board-certified radiologists, technologists, anesthesiologists and nurses who are specialty-trained to provide pediatric radiology services to your child.

• #64 Diagnoses, Symptoms And Treatment Of Brain Tumors | Pediatric Neurosurgery

  https://pediatricneurosurgery.org/diagnosis/brain-tumors

  Neurophysiological monitoring of infants and young children allows brain function to be monitored during brain tumor surgery. […] If your doctor suspects a brain tumor, pictures of the brain are usually taken, and this can be done by a computed tomography (CT) scan, or magnetic resonance imaging (MRI), or both. A CT scan or MRI may be done with an injection of dye in the vein that will enhance the machine’s ability to see the tumor. The brain picture will be read by a radiologist. The radiologist may have an idea of what type of brain tumor is present by the location and the way the images look. However, the only way to really know what type of brain tumor is present is to have a pathologist study it under a microscope. […] Once a final diagnosis is made, usually 5-10 days after surgery, a team of doctors will meet and determine the right treatment for your child. The team includes a neurosurgeon, radiologist, neuro-oncologist, and neuropsychologist, and a social worker.

• #65 How We Diagnose Brain Tumors | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/types/brain-tumors/diagnosis

  Complex brain cancer cases requiring multidisciplinary care are reviewed by the brain tumor diagnostic board and the treatment tumor board at weekly meetings that include representatives from all neuro-oncology clinical specialties. Results of all tumor tissue pathology tests are reviewed, and approaches to treatment are discussed. […] If your medical oncologist believes there may be a brain tumor present based on these test results, diagnostic imaging will be performed and analyzed in collaboration with our neuroradiologists. […] At the Center for Neuro-Oncology, diagnostic imaging is central before, during, and after treatment. Standard and unique imaging allow your clinical team to learn more about the characteristics of a brain tumor, as well as determine which areas of the brain are affected and which healthy tissue to avoid for the best and safest approach to treatment.

• #66 Frontiers | Pediatric brain tumors: A neuropathologist’s approach to the integrated diagnosis

  https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1143363/full

  Pediatric CNS tumors, in particular, rely heavily on the integration of molecular data with histologic, clinical, and radiographic features to reach the most accurate diagnosis. […] The integrated diagnosis was designed to incorporate multiple critical data types (i.e., tumor type, relevant molecular information, and tumor grade) into a single, line diagnosis. […] Histologic diagnosis and grading are typically based on analysis of H&E stained sections often in conjunction with ancillary immunohistochemical stains. […] Molecular testing is a key component to the integrated diagnosis and overall characterization of many CNS tumors. […] Even with the many advances in imaging techniques, histologic examination is still considered to be the gold standard for CNS tumor diagnosis. […] The diagnosis of CNS tumors should take into account the tumor location. […] The formulation of an integrated diagnosis should take into account all pertinent clinical, radiographic, histologic, immunohistochemical, and molecular information. […] The integrated diagnosis has become central to the WHO classification of CNS tumors.

• #67 Frontiers | Pediatric brain tumors: A neuropathologist’s approach to the integrated diagnosis

  https://www.frontiersin.org/articles/10.3389/fped.2023.1143363/full

  Pediatric CNS tumors, in particular, rely heavily on the integration of molecular data with histologic, clinical, and radiographic features to reach the most accurate diagnosis. […] The integrated diagnosis was designed to incorporate multiple critical data types (i.e., tumor type, relevant molecular information, and tumor grade) into a single, line diagnosis. […] Histologic assessment remains a critical component in the workup of CNS tumors. […] Molecular testing is a key component to the integrated diagnosis and overall characterization of many CNS tumors. […] Even with the many advances in imaging techniques, histologic examination is still considered to be the gold standard for CNS tumor diagnosis. […] The diagnosis of CNS tumors should take into account the tumor location. […] The formulation of an integrated diagnosis should take into account all pertinent clinical, radiographic, histologic, immunohistochemical, and molecular information. […] The integrated diagnosis has become central to the WHO classification of CNS tumors.

• #68 Symptoms and Diagnosis of Brain Tumors in Children | Norton Children’s

  https://nortonchildrens.com/services/cancer/conditions/brain-tumor/services/

  fMRI – During a functional MRI (fMRI), the patient will perform specific tasks that will be reflected in the brain. This test helps the surgeon plan surgery so as to avoid damaging healthy, functional parts of the brain while removing a tumor. fMRI can be used in children older than age 4. […] Biopsy – This procedure removes a small piece of tissue for examination and is the only definitive way to diagnose a brain tumor. A biopsy can be performed while removing the tumor or as an intermediate step if surgical removal isn’t possible because of the location or patient’s health. […] Lumbar puncture/spinal tap – A special needle is inserted into the lower back and into the spinal canal around the spinal cord. A small amount of cerebrospinal fluid, which surrounds the brain and spinal cord, can be removed and sent for testing.

• #69 MRI-based diagnosis and treatment of pediatric brain tumors: is tissue sample always needed?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8084800/

  Imaging features supportive of DIPG, in accordance with typical clinical symptoms, are considered sufficient for diagnosing DIPG and initiating empirical treatment. […] The diagnosis of DIPG based on radiological and clinical features is considered by most to be sufficient, and the current standard of care. […] The diagnosis of OPG is based on pathognomonic MRI findings, in combination with the diagnosis of NF1 and noticeable changes on eye exam. […] Therefore, surgical biopsy has practically no role in tumor diagnosis of OPG in NF1 children. […] However, biopsy is increasingly indicated once aggressive or transformed tumor behavior is suspected, focused not only on histologic confirmation of the tumor type and its histologic grade but also on genetic alterations, such as ATRX, CDKN2A, and TP53, suggestive of transformed or higher-grade tumors.

• #70 MRI-based diagnosis and treatment of pediatric brain tumors: is tissue sample always needed?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8084800/

  Traditional management of newly diagnosed pediatric brain tumors (PBTs) consists of cranial imaging, typically magnetic resonance imaging (MRI), and is frequently followed by tissue diagnosis, through either surgical biopsy or tumor resection. […] Current management of newly diagnosed pediatric brain tumors (PBTs) consists of central nervous system (CNS) imaging, typically magnetic resonance imaging (MRI), followed by tissue diagnosis, through either surgical biopsy or tumor resection. […] The aim of this review is to explore the role of MRI-based diagnosis and treatment of these PBTs in the current oncological era. […] Typical MRI findings and indications for surgical biopsy of these lesions are described. […] The standard treatment for DIPG, to date, remains focal radiation therapy to the pons; no surgical or chemotherapeutic strategy has shown improvement in overall survival.

• #71 MRI-based diagnosis and treatment of pediatric brain tumors: is tissue sample always needed?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8084800/

  Imaging features supportive of DIPG, in accordance with typical clinical symptoms, are considered sufficient for diagnosing DIPG and initiating empirical treatment. […] The diagnosis of DIPG based on radiological and clinical features is considered by most to be sufficient, and the current standard of care. […] The diagnosis of OPG is based on pathognomonic MRI findings, in combination with the diagnosis of NF1 and noticeable changes on eye exam. […] Therefore, surgical biopsy has practically no role in tumor diagnosis of OPG in NF1 children. […] However, biopsy is increasingly indicated once aggressive or transformed tumor behavior is suspected, focused not only on histologic confirmation of the tumor type and its histologic grade but also on genetic alterations, such as ATRX, CDKN2A, and TP53, suggestive of transformed or higher-grade tumors.

• #72

  https://link.springer.com/article/10.1007/s00381-021-05148-1

  Imaging features supportive of DIPG, in accordance with typical clinical symptoms, are considered sufficient for diagnosing DIPG and initiating empirical treatment. […] The diagnosis of DIPG based on radiological and clinical features is considered by most to be sufficient, and the current standard of care. […] Diagnosis of BTGs based on the typical MRI and MRS characteristics is sufficient. […] However, biopsy is increasingly indicated once aggressive or transformed tumor behavior is suspected, focused not only on histologic confirmation of the tumor type and its histologic grade but also on genetic alterations, such as ATRX, CDKN2A, and TP53, suggestive of transformed or higher-grade tumors. […] Pathognomonic MRI findings of OPG, in combination with the diagnosis of NF1 and noticeable changes on eye exam, lead to the diagnosis of OPG.

• #73 MRI-based diagnosis and treatment of pediatric brain tumors: is tissue sample always needed?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8084800/

  Imaging features supportive of DIPG, in accordance with typical clinical symptoms, are considered sufficient for diagnosing DIPG and initiating empirical treatment. […] The diagnosis of DIPG based on radiological and clinical features is considered by most to be sufficient, and the current standard of care. […] The diagnosis of OPG is based on pathognomonic MRI findings, in combination with the diagnosis of NF1 and noticeable changes on eye exam. […] Therefore, surgical biopsy has practically no role in tumor diagnosis of OPG in NF1 children. […] However, biopsy is increasingly indicated once aggressive or transformed tumor behavior is suspected, focused not only on histologic confirmation of the tumor type and its histologic grade but also on genetic alterations, such as ATRX, CDKN2A, and TP53, suggestive of transformed or higher-grade tumors.

• #74 MRI-based diagnosis and treatment of pediatric brain tumors: is tissue sample always needed?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8084800/

  Imaging features supportive of DIPG, in accordance with typical clinical symptoms, are considered sufficient for diagnosing DIPG and initiating empirical treatment. […] The diagnosis of DIPG based on radiological and clinical features is considered by most to be sufficient, and the current standard of care. […] The diagnosis of OPG is based on pathognomonic MRI findings, in combination with the diagnosis of NF1 and noticeable changes on eye exam. […] Therefore, surgical biopsy has practically no role in tumor diagnosis of OPG in NF1 children. […] However, biopsy is increasingly indicated once aggressive or transformed tumor behavior is suspected, focused not only on histologic confirmation of the tumor type and its histologic grade but also on genetic alterations, such as ATRX, CDKN2A, and TP53, suggestive of transformed or higher-grade tumors.

• #75

  https://link.springer.com/article/10.1007/s00381-021-05148-1

  Imaging features supportive of DIPG, in accordance with typical clinical symptoms, are considered sufficient for diagnosing DIPG and initiating empirical treatment. […] The diagnosis of DIPG based on radiological and clinical features is considered by most to be sufficient, and the current standard of care. […] Diagnosis of BTGs based on the typical MRI and MRS characteristics is sufficient. […] However, biopsy is increasingly indicated once aggressive or transformed tumor behavior is suspected, focused not only on histologic confirmation of the tumor type and its histologic grade but also on genetic alterations, such as ATRX, CDKN2A, and TP53, suggestive of transformed or higher-grade tumors. […] Pathognomonic MRI findings of OPG, in combination with the diagnosis of NF1 and noticeable changes on eye exam, lead to the diagnosis of OPG.

• #76 MRI-based diagnosis and treatment of pediatric brain tumors: is tissue sample always needed?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8084800/

  Diagnosis of TS is based on various clinical criteria, as well as genetic alteration (of TS1 or TS2 genes). […] Diagnosis can be made based on a clinical/genetic diagnosis of TS and a typical tumor location without histology. […] The diagnosis of most PBTs must be confirmed through histopathology and molecular biology, achieved by surgical biopsy or resection. […] However, diagnosis based on typical MRI findings, in conjunction with the clinical presentation, is possible for a select group of PBTs. […] In selected cases, molecular profiling might significantly impact treatment and prognosis, justifying a biopsy within the scope of clinical trials, as the route to personalized medicine tailored to the specific tumor.

• #77 MRI-based diagnosis and treatment of pediatric brain tumors: is tissue sample always needed?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8084800/

  Diagnosis of TS is based on various clinical criteria, as well as genetic alteration (of TS1 or TS2 genes). […] Diagnosis can be made based on a clinical/genetic diagnosis of TS and a typical tumor location without histology. […] The diagnosis of most PBTs must be confirmed through histopathology and molecular biology, achieved by surgical biopsy or resection. […] However, diagnosis based on typical MRI findings, in conjunction with the clinical presentation, is possible for a select group of PBTs. […] In selected cases, molecular profiling might significantly impact treatment and prognosis, justifying a biopsy within the scope of clinical trials, as the route to personalized medicine tailored to the specific tumor.

• #78

  https://link.springer.com/article/10.1007/s00381-021-05148-1

  Diagnosis can be made based on a clinical/genetic diagnosis of TS and a typical tumor location without histology. […] The diagnosis of most PBTs must be confirmed through histopathology and molecular biology, achieved by surgical biopsy or resection. However, diagnosis based on typical MRI findings, in conjunction with the clinical presentation, is possible for a select group of PBTs.

• #79 Improving diagnosis of pediatric central nervous system tumours: aiming for early detection

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5367991/

  Brain tumours have no unique pathognomonic features, which often makes early diagnosis difficult. Children commonly present with symptoms that may (but do not necessarily) reflect increased intracranial pressure. […] Despite advancement in imaging techniques and better access to computed tomography and magnetic resonance imaging, the prediagnostic symptomatic interval has remained virtually constant over the last several decades. […] Time to diagnosis affects time to treatment, and delays may lead to neurologic, developmental and neuroendocrinologic morbidity, such as loss of visual pathway or hypothalamic pituitary axis with supratentorial tumours, as well as substantial long-term deficits involving physical, sensory, cognitive, neurologic and endocrine complications. […] Physicians should consider CNS tumours in the differential diagnosis for children with headache, vomiting, lethargy, ataxia, visual changes, prolonged torticollis, nystagmus, papilledema or seizures, and should consider appropriate imaging and specialist referral according to the history and a comprehensive physical examination.

• #80 Improving diagnosis of pediatric central nervous system tumours: aiming for early detection

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5367991/

  Brain tumours have no unique pathognomonic features, which often makes early diagnosis difficult. Children commonly present with symptoms that may (but do not necessarily) reflect increased intracranial pressure. […] Despite advancement in imaging techniques and better access to computed tomography and magnetic resonance imaging, the prediagnostic symptomatic interval has remained virtually constant over the last several decades. […] Time to diagnosis affects time to treatment, and delays may lead to neurologic, developmental and neuroendocrinologic morbidity, such as loss of visual pathway or hypothalamic pituitary axis with supratentorial tumours, as well as substantial long-term deficits involving physical, sensory, cognitive, neurologic and endocrine complications. […] Physicians should consider CNS tumours in the differential diagnosis for children with headache, vomiting, lethargy, ataxia, visual changes, prolonged torticollis, nystagmus, papilledema or seizures, and should consider appropriate imaging and specialist referral according to the history and a comprehensive physical examination.

• #81 MRI and AI could significantly reduce pediatric brain tumor diagnosis time

  https://medicalxpress.com/news/2024-06-mri-ai-significantly-pediatric-brain.html

  „Time is so important in cancer diagnosis so our findings on different types of medulloblastoma having a detectable signature metabolism could be game changing for quickly diagnosing, and then offering the best possible treatment for children.” […] „Providing a rapid diagnosis using innovative scanning and AI (artificial intelligence) techniques, has the potential to revolutionize patient management, allowing early non-invasive diagnosis, tailoring of treatment decisions and reducing the period of uncertainty for patients and parents while awaiting a full diagnosis.” […] „Developing quicker, less invasive ways to accurately diagnose the different types of medulloblastoma, the most common malignant brain tumor in children, is a crucial step in improving outcomes for young patients.” […] „This important study has identified a new way to distinguish between the four subgroups of medulloblastoma. This discovery paves the way for the development of simple imaging tests that could quickly and accurately diagnose the different types of medulloblastoma.”

• #82 Advanced Neuroimaging Approaches to Pediatric Brain Tumors

  https://www.mdpi.com/2072-6694/14/14/3401

  Advanced imaging techniques, however, provide valuable insight about pediatric brain tumors by offering the quantitative and qualitative assessment of brain microstructures and physiological changes due to pathology. […] In this paper, a brief review of pediatric brain cancers, by type, is provided followed by a comprehensive description of advanced imaging techniques. These techniques include both those with clinical applications that are currently utilized for the assessment and evaluation of pediatric brain tumors and imaging modalities that are still being assessed for their broader value in the clinic.

• #83 MRI and AI could significantly reduce pediatric brain tumor diagnosis time

  https://medicalxpress.com/news/2024-06-mri-ai-significantly-pediatric-brain.html

  „Time is so important in cancer diagnosis so our findings on different types of medulloblastoma having a detectable signature metabolism could be game changing for quickly diagnosing, and then offering the best possible treatment for children.” […] „Providing a rapid diagnosis using innovative scanning and AI (artificial intelligence) techniques, has the potential to revolutionize patient management, allowing early non-invasive diagnosis, tailoring of treatment decisions and reducing the period of uncertainty for patients and parents while awaiting a full diagnosis.” […] „Developing quicker, less invasive ways to accurately diagnose the different types of medulloblastoma, the most common malignant brain tumor in children, is a crucial step in improving outcomes for young patients.” […] „This important study has identified a new way to distinguish between the four subgroups of medulloblastoma. This discovery paves the way for the development of simple imaging tests that could quickly and accurately diagnose the different types of medulloblastoma.”

• #84 Improving diagnosis of pediatric central nervous system tumours: aiming for early detection

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5367991/

  Brain tumours have no unique pathognomonic features, which often makes early diagnosis difficult. Children commonly present with symptoms that may (but do not necessarily) reflect increased intracranial pressure. […] Despite advancement in imaging techniques and better access to computed tomography and magnetic resonance imaging, the prediagnostic symptomatic interval has remained virtually constant over the last several decades. […] Time to diagnosis affects time to treatment, and delays may lead to neurologic, developmental and neuroendocrinologic morbidity, such as loss of visual pathway or hypothalamic pituitary axis with supratentorial tumours, as well as substantial long-term deficits involving physical, sensory, cognitive, neurologic and endocrine complications. […] Physicians should consider CNS tumours in the differential diagnosis for children with headache, vomiting, lethargy, ataxia, visual changes, prolonged torticollis, nystagmus, papilledema or seizures, and should consider appropriate imaging and specialist referral according to the history and a comprehensive physical examination.

• #85 Pediatric Brain Tumors: What You Need To Know | Tisch Brain Tumor Center

  https://tischbraintumorcenter.duke.edu/blog/pediatric-brain-tumors-what-you-need-know

  Recognizing the signs of pediatric brain tumors is crucial for early diagnosis and treatment. […] Pediatric brain tumor diagnosis involves a combination of imaging tests, such as MRI and CT scans, and a biopsy for conclusive results. […] Once diagnosed, treatment options may include surgery, radiation therapy, chemotherapy, or a combination of these approaches. The choice of treatment depends on the tumor’s type, size, and location. […] For most cases, the precise cause remains unknown, making early detection and treatment critical. […] Unlike adults, children’s brains are still growing, so doctors prefer to surgically remove tumors early to prevent further growth. After surgery, chemotherapy may be given to some children. However, doctors rarely use it for young kids due to the strong radiation beams involved, which can be risky in children.

• #86 Improving diagnosis of pediatric central nervous system tumours: aiming for early detection

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5367991/

  Brain tumours have no unique pathognomonic features, which often makes early diagnosis difficult. Children commonly present with symptoms that may (but do not necessarily) reflect increased intracranial pressure. […] Despite advancement in imaging techniques and better access to computed tomography and magnetic resonance imaging, the prediagnostic symptomatic interval has remained virtually constant over the last several decades. […] Time to diagnosis affects time to treatment, and delays may lead to neurologic, developmental and neuroendocrinologic morbidity, such as loss of visual pathway or hypothalamic pituitary axis with supratentorial tumours, as well as substantial long-term deficits involving physical, sensory, cognitive, neurologic and endocrine complications. […] Physicians should consider CNS tumours in the differential diagnosis for children with headache, vomiting, lethargy, ataxia, visual changes, prolonged torticollis, nystagmus, papilledema or seizures, and should consider appropriate imaging and specialist referral according to the history and a comprehensive physical examination.

• #87 Brain Tumor Facts

  https://braintumor.org/brain-tumors/about-brain-tumors/brain-tumor-facts/

  Approximately 3,920 new cases of primary childhood brain tumors are expected to be diagnosed in 2023. […] Brain tumors are the most commonly diagnosed solid cancer in children ages 0-14 years, as well as the leading cause of childhood cancer-related death. […] The five-year relative survival rate for all primary childhood brain tumors is 83.1%. […] For primary malignant childhood tumors, the five-year relative survival rate is 75.6%. […] The five-year relative survival rate for all primary pediatric brain tumors (0-19) is 83.9%. […] For malignant tumors, the five-year relative survival rate is 75.6%. […] Pediatric brain tumors are the leading cause of cancer-related death among children and adolescents ages 0-19 years. […] AT/RT and high-grade gliomas have the lowest relative survival after diagnosis for patients 0-19 years with a brain tumor. […] Relative survival rates generally improve with increasing age at diagnosis in this population group, with poorest survival in those less than a year old at diagnosis.

• #88 Childhood Brain Tumor Diagnosis | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/childhood-brain-tumors/childhood-brain-tumor-diagnosis.html

  Early and accurate diagnosis of a childhood brain tumor can increase the chances for successful treatment. […] If your child has symptoms of a brain tumor, the doctor will examine your child carefully and ask you questions about your childs and familys medical history. […] One or more diagnostic test may be used to find out if your child has a brain tumor and if it has spread. These tests also may be used to find out if treatment is working. […] If imaging tests show an area that may be a brain tumor, a biopsy almost always is necessary for diagnosis. […] A biopsy may be done during surgery in which all or part of the brain tumor is removed. […] If a tumor is difficult to reach, a CT scan may be used for to place a hollow needle inside the tumor and remove a small amount of tissue. […] A small amount of CSF (cerebrospinal fluid, which is the clear liquid in and around the brain and spine) is removed with a needle and looked at with a microscope.

• #89 Pediatric Brain Tumor Symptoms & Diagnosis | Baptist Health Miami Cancer Institute

  https://baptisthealth.net/services/cancer-care/miami-cancer-institute/our-approach/pediatric-cancers/brain-tumors/symptoms-and-diagnosis

  Each child experiences symptoms differently. The size and location of a tumor also affect symptoms. Among the most common symptoms are: […] To diagnose and better analyze your child’s condition and help determine the best treatment your child’s doctor will complete a thorough medical history and order a number of tests. Depending on the type of brain tumor suspected, your child’s tests may include: […] A neurological exam, testing reflexes, muscle strength, eye and mouth movement, coordination and alertness. […] Computed tomography (CT or CAT) scans. […] Magnetic resonance imaging (MRI). […] X-rays. […] An angiogram, using dye and X-rays to view the blood vessels in the brain. […] A myelogram, an X-ray of the spine that is similar to an angiogram. […] Lumbar puncture or spinal tap. […] Positron emission tomography (PET) scan, a nuclear medicine procedure that measures the metabolic activity of cells.

• #90 MRI-based diagnosis and treatment of pediatric brain tumors: is tissue sample always needed?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8084800/

  Diagnosis of TS is based on various clinical criteria, as well as genetic alteration (of TS1 or TS2 genes). […] Diagnosis can be made based on a clinical/genetic diagnosis of TS and a typical tumor location without histology. […] The diagnosis of most PBTs must be confirmed through histopathology and molecular biology, achieved by surgical biopsy or resection. […] However, diagnosis based on typical MRI findings, in conjunction with the clinical presentation, is possible for a select group of PBTs. […] In selected cases, molecular profiling might significantly impact treatment and prognosis, justifying a biopsy within the scope of clinical trials, as the route to personalized medicine tailored to the specific tumor.

• #91

  https://link.springer.com/article/10.1007/s00381-021-05148-1

  Diagnosis can be made based on a clinical/genetic diagnosis of TS and a typical tumor location without histology. […] The diagnosis of most PBTs must be confirmed through histopathology and molecular biology, achieved by surgical biopsy or resection. However, diagnosis based on typical MRI findings, in conjunction with the clinical presentation, is possible for a select group of PBTs.

• #92 Brain Tumors in Children – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=brain-tumors-in-children-90-P02745

  Brain tumors can occur at any age. Brain tumors that occur in infants and children are very different from adult brain tumors, both in terms of the type of cells and the responsiveness to treatment. […] In addition, both the American Academy of Pediatrics and the National Cancer Institute recommend that children receive cancer diagnosis and treatment at one of the more than 200 medical centers in the U.S. that specialize in pediatric cancers. The organizations cite research studies that show 20% to 40% higher survival rates when children receive care in such specialized centers. […] In addition to a complete medical history and physical examination of your child, examination procedures for a brain tumor may include: […] Examination of a brain tumor depends mostly on the types of cells in which the tumor begins and the tumor location. […] Specific treatment for brain tumors will be determined by your child’s doctor based on: […] Continuous follow-up care is essential for a child diagnosed with a brain tumor.

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