Article Figures & Data
Figures
- Fig 1.
Diffuse midline gliomas within the posterior fossa. A, FLAIR, T1 postgadolinum, and ADC maps of infratentorial diffuse gliomas demonstrate 2 distinct appearances, with the first type being centered within the pons with expansion of the pons and engulfment of the basilar artery (14 patients). The second type was centered within the vermis and cerebellar peduncle with extension into the fourth ventricle and involvement of the posterior pons (5 patients). B, Imaging features of both the histone H3 K27M and wildtype tumors were heterogeneous with respect to necrosis, patterns of enhancement, edema, and infiltrative features. Black bars represent the presence of the feature; white bars represent lack of the feature.
- Fig 2.
Imaging of tumor progression in histone H3 K27M mutant tumors. FLAIR and T1-weighted contrast-enhancing images demonstrate local infiltrative (A) and CSF-based progression (B) in histone H3 K27M mutants.
- Fig 3.
Imaging of tumor progression in histone H3 wildtype tumors. FLAIR and T1-weighted contrast-enhancing images demonstrate mixed local infiltrative progression with CSF-based metastatic disease (A) and local infiltrative progression (B).
- Fig 4.
Imaging of midline gliomas centered within the thalamus. Midline gliomas with histone H3 K27M mutation centered within the thalamus had 2 specific imaging presentations, with (A) and without (B) contrast enhancement. Three patients had contrast enhancement, and 3 patients did not. C, Imaging features within the thalamic gliomas based on the presence of the histone H3 K27M mutation. Black bars represent the presence of the feature; white bars represent lack of the feature.
- Fig 5.
Imaging of cervical spine histone H3 K27M mutant gliomas. T2-weighted and postcontrast T1-weighted imaging of cervical spine glioblastomas that presented with subependymal metastatic disease and evidence of significant progression involving the subependymal surfaces of the lateral ventricles and the folia of the cerebellum at 5 months after initial diagnosis.
Tables
All Patients (n = 33) Histone H3 K27M Mutant (n = 24) Histone H3 Wildtype (n = 9) Age Mean 115.8 mo 108.5 mo 135.2 mo Range 8.2–232 mo 32–232 mo 8.2–211 mo Sex Male 25 17 8 Female 8 7 1 Anatomic location Subcallosal 1 1 0 Thalamus 9 6 3 Midbrain tectum 2 0 2 Pons 14 11 3 Vermis/fourth ventricle 5 4 1 Cervical spine 2 2 0 ↵a Data are number and age.
All Patients (n = 33) Histone H3 K27 Mutant (n = 24) Histone H3 Wildtype (n = 9) Multifocality 5 5 0 Contrast enhancement 22 16 6 Cystic component or necrosis 18 15 3 Edema 4 4 0 Infiltrative pattern 27 18 9 Mass effect 32 24 8 Irregular border 27 18 9 CSF-based metastases 7 6 1 Direct cortical invasion 12 9 3 ↵a Data are number.
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