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The Neuroradiological Spectra of Adult and Pediatric Medulloblastoma Differ

Results from a Literature-based Meta-analysis

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Abstract

Purpose

Current knowledge on the spectrum of the neuroradiological appearance of adult medulloblastoma is sparse. Due to the rarity of the disease, adult patients were generally diagnosed and treated similar to children; however, pediatric and adult medulloblastomas display substantial molecular differences that may influence the neuroradiological phenotype. This study therefore aimed at assessment of the neuroradiological spectrum of adult medulloblastoma in comparison to pediatric tumors.

Methods

All available publications on adult medulloblastoma published until June 2013 were screened for imaging data on single patients. A total of 109 patients were identified and compared to 118 pediatric patients described in 4 cohorts.

Results

The average age of the adult patients was 34.3 years. Most adult medulloblastomas (57.6 %) were localized laterally (vs. 14.4 % in pediatric patients). On T1-weighted sequences, only 41.1 % of all adult medulloblastomas appeared hypointense (vs. 89.3 %) and 69.6 % were hyperintense on T2 sequences (vs. 83 %). In contrast to pediatric patients only 53.3 % showed strong contrast enhancement (pediatric patients 77.1 %), while the contrast uptake of the remainder was described as subtle, moderate or lacking. Contrast enhancement was more often described as inhomogeneous in adults (35.5 % as compared to 15.2 % in children) and 26.4 % had cysts.

Conclusion

Although the neuroradiological spectrum of medulloblastoma in adults was similar to children, an atypical presentation with inhomogeneous contrast enhancement, more hyperintense signal on T1 and a more hypointense signal on T2-weighted sequences was common. Given the rarity of the tumor, awareness of these differences constitutes a prerequisite to avoid delays in diagnostics.

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Acknowledgements

The authors would like to thank Prof. Gerhard Schuierer, Center of Neuroradiology, University and District Hospital, Regensburg for his very valuable comments and proofreading of the manuscript. This work was supported by a career award to young female scientists of the RWTH Aachen, Medical School to D.B. Parts of the project were funded by the in-house research support of the RWTH Aachen, Medical School (START-Program) to D.B, and free research grants, University Hospital, Odense (to D.B. and C.P.B).

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Authors and Affiliations

  1. Department of Clinical Research, University of Southern Denmark, Sdr. Boulevard 29, 5000, Odense, Denmark

    Dagmar Beier & Christoph Patrick Beier

  2. Department of Neurology, University Hospital of Odense, Sdr. Boulevard 29, 5000, Odense, Denmark

    Dagmar Beier & Christoph Patrick Beier

  3. Department of Neurology, University Hospital Aachen, Pauwelsstraße 20, 52074, Aachen, Germany

    Dagmar Beier, Selin Kocakaya & Christoph Patrick Beier

  4. Wilhelm Sander NeuroOncology Unit and Department of Neurology, University Hospital Regensburg, Universitätsstraße 80, 93053, Regensburg, Germany

    Peter Hau

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  1. Dagmar Beier
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  2. Selin Kocakaya
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  3. Peter Hau
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  4. Christoph Patrick Beier
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Correspondence to Dagmar Beier.

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Conflict of Interest

D. Beier, S. Kocakaya, P. Hau and C.P. Beier state that there are no conflicts of interest.

Ethical standards

The study was carried out in accordance with the Helsinki Declaration of 1975 (in its most recently amended version).

Additional information

The authors D. Beier and S. Kocakaya contributed equally to the manuscript.

Appendix

Appendix

Table A.1 MRI appearance of adult medulloblastoma depending on the histological subtype
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Fig. A.1
figure a

PRISMA flow chart

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Beier, D., Kocakaya, S., Hau, P. et al. The Neuroradiological Spectra of Adult and Pediatric Medulloblastoma Differ. Clin Neuroradiol 28, 99–107 (2018). https://doi.org/10.1007/s00062-016-0517-0

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  • DOI: https://doi.org/10.1007/s00062-016-0517-0

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