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Postoperative Surveillance Magnetic Resonance Imaging for Cerebellar Astrocytoma

Published online by Cambridge University Press:  02 December 2014

Michael Vassilyadi ,
Mohammed F. Shamji ,
Zachary Tataryn ,
Daniel Keene  and
Enrique Ventureyra
Michael Vassilyadi*
Affiliation:
Division of Neurosurgery, The Ottawa Hospital Division of Neurosurgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
Mohammed F. Shamji
Affiliation:
Division of Neurosurgery, The Ottawa Hospital
Zachary Tataryn
Affiliation:
Division of Neurosurgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
Daniel Keene
Affiliation:
Division of Neurology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
Enrique Ventureyra
Affiliation:
Division of Neurosurgery, The Ottawa Hospital Division of Neurosurgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
*
The Children’s Hospital of Eastern Ontario, Division of Neurosurgery, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada.
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Abstract

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Introduction:

Patients with low grade astrocytomas generally have good prognosis when total resection can be achieved, but surveillance neuroimaging is commonly performed to detect recurrence or progression. This study evaluated the utility and yield of such strategy for pilocytic and non-pilocytic cerebellar astrocytomas.

Methods:

A 20-year retrospective review was performed of patients undergoing resection of cerebellar astrocytoma at a single institution. A negative MRI string (NMS) ratio was computed as the fraction of total follow-up period over which surveillance neuroimaging was negative for recurrence or progression. Chi-squared analysis differentiated NMS ratio by resection extent and lesion histopathology.

Results:

Twenty-eight patients with pilocytic (n=15) and non-pilocytic (n=13) astrocytoma underwent 34 craniotomies, with total resection in 19 cases. Surveillance MRIs (n=167) among total resection patients were uniformly negative for recurrent disease at average seven years follow-up (NMS ratio = 1.0). The 43 surveillance MRIs among subtotal resection patients revealed disease progression in two patients within six months of operation (NMS ratio = 0.78, p<0.05). No differences in NMS ratio were observed between pilocytic and non-pilocytic astrocytoma subtypes.

Discussion:

This study illustrates pediatric patients with low-grade cerebellar astrocytomas undergoing total resection may not benefit from routine surveillance neuroimaging, primarily because of low recurrence likelihood. Patients with subtotal resection may benefit from surveillance of residual disease, with further work aimed at exploring the schedule of such follow-up.

Type
Other
Information
Canadian Journal of Neurological Sciences , Volume 36 , Issue 6 , November 2009 , pp. 707 - 712
Copyright
Copyright © The Canadian Journal of Neurological 2009

References

1.Pollack, IF.Brain tumors in children. N Engl J Med. 1994 Dec 1;331(22):1500–7.Google Scholar
2.Smoots, DW, Geyer, JR, Lieberman, DM, Berger, MS.Predicting disease progression in childhood cerebellar astrocytoma. Childs Nerv Syst. 1998 Nov;14(11):636–48.Google Scholar
3.Saunders, DE, Phipps, KP, Wade, AM, Hayward, RD.Surveillance imaging strategies following surgery and/or radiotherapy for childhood cerebellar low-grade astrocytoma. J Neurosurg. 2005 Mar;102 Suppl 2:172–8.Google Scholar
4.Boch, AL, Cacciola, F, Mokhtari, K, Kujas, M, Philippon, J.Benign recurrence of a cerebellar pilocytic astrocytoma 45 years after gross total resection. Acta Neurochir (Wien). 2000;142(3):341–6.Google Scholar
5.Krieger, MD, Gonzalez-Gomez, I, Levy, ML, McComb, JG.Recurrence patterns and anaplastic change in a long-term study of pilocytic astrocytomas. Pediatr Neurosurg. 1997 Jul;27(1):1–11Google Scholar
6.Korones, DN, Butterfield, R, Meyers, SP, Constine, LS.The role of surveillance magnetic resonance imaging (MRI) scanning in detecting recurrent brain tumors in asymptomatic children. J Neurooncol. 2001 May;53(1):33–8.Google Scholar
7.Steinbok, P, Hentschel, S, Cochrane, DD, Kestle, JR.Value of postoperative surveillance imaging in the management of children with some common brain tumors. J Neurosurg. 1996 May;84(5):726–32.Google Scholar
8.Mendel, E, Levy, ML, Raffel, C, McComb, JG, Pikus, H, Nelson, MD Jr., et al.Surveillance imaging in children with primitive neuroectodermal tumors. Neurosurgery. 1996 Apr;38(4):692–4; discussion 694-5.CrossRefGoogle ScholarPubMed
9.Minn, AY, Pollock, BH, Garzarella, L, Dahl, GV, Kun, LE, Ducore, JM, et al.Surveillance neuroimaging to detect relapse in childhood brain tumors: a Pediatric Oncology Group study. J Clin Oncol. 2001 Nov 1;19(21):4135–40.Google Scholar
10.Saunders, DE, Hayward, RD, Phipps, KP, Chong, WK, Wade, AM.Surveillance neuroimaging of intracranial medulloblastoma in children: how effective, how often, and for how long? J Neurosurg. 2003 Aug;99(2):280–6.Google Scholar
11.Sutton, LN, Cnaan, A, Klatt, L, Zhao, H, Zimmerman, R, Needle, M, et al.Postoperative surveillance imaging in children with cerebellar astrocytomas. J Neurosurg. 1996 May;84(5):721–5.CrossRefGoogle ScholarPubMed
12.de Graaf, N, Hew, JM, Fock, JM, Kamps, WA, de Graaf, SS.Predictive value of clinical evaluation in the follow-up of children with a brain tumor. Med Pediatr Oncol. 2002 Apr;38(4):254–7.Google Scholar
13.Cravero, JP, Beach, ML, Blike, GT, Gallagher, SM, Hertzog, JH.The incidence and nature of adverse events during pediatric sedation/anesthesia with propofol for procedures outside the operating room: a report from the Pediatric Sedation Research Consortium. Anesth Analg. 2009 Mar;108(3):795–804.Google Scholar
14.Machata, AM, Willschke, H, Kabon, B, Kettner, SC, Marhofer, P.Propofol-based sedation regimen for infants and children undergoing ambulatory magnetic resonance imaging. Br J Anaesth. 2008 Aug;101(2):239–43.Google Scholar
15.Abdollahzadeh, M, Hoffman, HJ, Blazer, SI, Becker, LE, Humphreys, RP, Drake, JM, et al.Benign cerebellar astrocytoma in childhood: experience at the Hospital for Sick Children 1980-1992. Childs Nerv Syst. 1994 Aug;10(6):380–3.Google Scholar
16.Dirven, CM, Mooij, JJ, Molenaar, WM.Cerebellar pilocytic astrocytoma: a treatment protocol based upon analysis of 73 cases and a review of the literature. Childs Nerv Syst. 1997 Jan;13(1):17–23.Google Scholar
17.Palma, L, Celli, P, Mariottini, A.Long-term follow-up of childhood cerebellar astrocytomas after incomplete resection with particular reference to arrested growth or spontaneous tumour regression. Acta Neurochir (Wien). 2004 Jun;146(6):581–8; discussion 588.Google Scholar
18.Schneider, JH Jr., Raffel, C, McComb, JG.Benign cerebellar astrocytomas of childhood. Neurosurgery. 1992 Jan;30(1):58–62; discussion 62-3.Google Scholar
19.Tomita, T, Chou, P, Reyes-Mugica, M.IV ventricle astrocytomas in childhood: clinicopathological features in 21 cases. Childs Nerv Syst. 1998 Oct;14(10):537–46.Google Scholar
20.Austin, EJ, Alvord, EC Jr. Recurrences of cerebellar astrocytomas: a violation of Collins’ law. J Neurosurg. 1988 Jan;68(1):41–7.Google Scholar
21.Dirven, CM, Koudstaal, J, Mooij, JJ, Molenaar, WM.The proliferative potential of the pilocytic astrocytoma: the relation between MIB-1 labeling and clinical and neuro-radiological follow-up. J Neurooncol. 1998 Mar;37(1):9–16.Google Scholar
22.Ito, S, Hoshino, T, Shibuya, M, Prados, MD, Edwards, MS, Davis, RL.Proliferative characteristics of juvenile pilocytic astrocytomas determined by bromodeoxyuridine labeling. Neurosurgery. 1992 Sep;31(3):413–8; discussion 419.CrossRefGoogle ScholarPubMed
23.Bernhardtsen, T, Laursen, H, Bojsen-Moller, M, Gjerris, F.Subclassification of low-grade cerebellar astrocytoma: is it clinically meaningful? Childs Nerv Syst. 2003 Nov;19(10–11):729–35.CrossRefGoogle ScholarPubMed