Imaging changes with or without neurological symptoms after proton therapy in pediatric posterior fossa tumors; initial experience of the Dutch national cohort.

Background And Purpose: The incidence of proton therapy (PT)-related imaging changes in the central nervous system, and associated symptoms, varies widely in literature. The aim of this study was to assess imaging changes after implementation of intensity-modulated pencil beam scanning in a national cohort of pediatric posterior fossa (PF) tumors.

Materials And Methods: All pediatric PF tumor patients treated in the XXX with PT between 06-2018 and 12-2022 were analyzed.

Identifying Risk Factors for New-Onset Postoperative Seizures in Pediatric Brain Tumor Patients: A Comprehensive Retrospective Analysis.

Introduction: Surgical resection of intracranial tumors in pediatric patients poses the potential risk of new-onset postoperative seizures, prompting debates over the prophylactic use of anti-seizure medication(ASMs). This retrospective study focusses on the incidence and risk factors associated with the occurrence of new-onset postoperative seizures within 30 days following surgery in pediatric patients with brain tumors who did not receive ASM prophylaxis pre- and perioperatively.

Methods: A meticulous review of clinical records spanning from June 2018 to December 2022 was conducted, examining data from pediatric patients undergoing craniotomies for intracranial tumors.

Long-term survival and cure fraction estimates for paediatric central nervous system tumours in 31 European countries (EUROCARE-6): a population-based study.

Background: Clinically relevant survival outcomes, including cure fraction estimates, and long-term survival outcomes of paediatric CNS tumours from large-scale databases have not been reported for Europe. Moreover, various biases hinder direct geographical comparisons, thereby limiting the effective translation of population-based findings into cancer care, surveillance, and research. We aimed to estimate these survival outcomes across Europe through the EUROCARE database.

Multi-modal analysis of pediatric pilocytic astrocytomas reveals tumor location-associated cellular and transcriptional heterogeneity.

Background: Pilocytic astrocytomas (PAs) are the most common pediatric central nervous system (CNS) tumors, which present with limited genetic but significant clinical heterogeneity. Current treatment strategies are partly effective, but tumors often progress, and patients experience long-term side effects, highlighting the need for additional novel therapeutic approaches. A promising alternative approach could be targeting the tumor immune microenvironment (TIME), however, a comprehensive overview of the TIME of PAs across different anatomical tumor locations is currently lacking.

A cycling, progenitor-like cell population at the base of atypical teratoid rhabdoid tumor subtype differentiation trajectories.

Background: Atypical teratoid rhabdoid tumors (ATRTs) are highly aggressive pediatric central nervous system tumors defined by the inactivation of the SMARCB1 gene. Despite the identification of three distinct molecular subtypes, each defined by unique clinical and molecular characteristics, no subtype-specific therapeutic strategies are currently available. This highlights an urgent need to deepen our understanding of the cellular heterogeneity and developmental origins of ATRTs.

The many different clinical faces of acquired hypothalamic dysfunction: a retrospective cohort study in the Netherlands.

Background: Acquired hypothalamic dysfunction, occurring at diagnosis or after treatment for a childhood (supra)sellar brain tumor, can have severe consequences. While morbid obesity and pituitary dysfunction are easily recognized, the other consequences of hypothalamic dysfunction (HD), such as hypothermia, sleep disturbance, or behavioral issues, are less well-known and may be overlooked. In addition, hypothalamic dysfunction may present differently in each patient hampering diagnostic and therapeutic efficacy.

External Ventricular Drain Placement Using Active Augmented Reality Guidance: A Proof of Concept of a Clinically Integrable System.

Background And Objectives: Suboptimal placement occurs in 26% of external ventricular drain (EVD) procedures performed using traditional freehand methods. We developed a low-cost augmented reality stereotactic navigation system aimed at improving accuracy and safety of the procedure, which is readily compatible with existing Picture Archiving and Communication Systems and automated image segmentation algorithms.

Methods: The system integrates cloud storage, image segmentation, trajectory planning, point-based image-to-patient registration, and real-time 3-dimensional guidance superimposed over the surgical field.

Do we need B7-H3 immunohistochemistry for the inclusion of children with high-grade central nervous system tumors in clinical trials targeting B7-H3?

Background: Pediatric high-grade central nervous system (pHG-CNS) tumors are the leading cause of childhood cancer-related deaths, partly due to poor response to standard treatments. B7-H3 is reportedlyexpressed in pHG-CNS tumors, making antigen-targeting therapies, including anti-B7-H3 chimeric antigen receptor T-cell (CAR-T) therapy, promising. However, given substantial inter-tumoral protein expression diversity in CNS tumors, it's unclear which patients might benefit from these treatments.

Gross tumor volume increase and need for adaptive radiotherapy in pediatric-type diffuse high-grade glioma of the midline structures.

Introduction: Current pediatric-type diffuse high-grade glioma radiotherapy protocols apply a 1.0 cm clinical target volume (CTV) margin around the gross tumor volume (GTV). However, in adults with glioblastoma, large variations in GTV are observed during radiotherapy.

Neuroimaging of postoperative pediatric cerebellar mutism syndrome: a systematic review.

Background: Postoperative pediatric cerebellar mutism syndrome (ppCMS) poses serious morbidity after posterior fossa tumor surgery. Neuroimaging studies aim to understand its pathophysiology, yet these vary in methodology and outcome measures. Therefore, we systematically reviewed the current literature to evaluate the evidence for differences in neuroimaging features between children with and without ppCMS.

Development and Validation of a Neurosurgical Phantom for Simulating External Ventricular Drain Placement.

This study aimed to develop and validate a cost-effective, customizable patient-specific phantom for simulating external ventricular drain placement, combining image segmentation, 3-D printing and molding techniques. Two variations of the phantom were created based on patient MRI data, integrating a realistic skin layer with anatomical landmarks, a 3-D printed skull, an agarose polysaccharide gel brain, and a ventricular cavity. To validate the phantom, 15 neurosurgeons, residents, and physician assistants performed 30 EVD placements.

VGLL fusions define a new class of intraparenchymal central nervous system schwannoma.

Background: Intracerebral schwannomas are rare tumors resembling their peripheral nerve sheath counterparts but localized in the central nervous system (CNS). They are not classified as a separate tumor type in the 2021 World Health Organization classification. This study aimed to compile and characterize these rare neoplasms morphologically and molecularly.

M&M: an RNA-seq based pan-cancer classifier for paediatric tumours.

Background: With many rare tumour types, acquiring the correct diagnosis is a challenging but crucial process in paediatric oncology. Historically, this is done based on histology and morphology of the disease. However, advances in genome wide profiling techniques such as RNA sequencing now allow the development of molecular classification tools.

Long-term risk and characteristics of cerebrovascular events after upper body radiotherapy among childhood cancer survivors in the DCCSS-LATER cohort.

Cerebrovascular events (CVEs) are serious late adverse events among childhood cancer survivors. We estimated the incidence and risk factors of symptomatic CVEs and described the clinical characteristics among childhood cancer survivors after upper body radiotherapy. The Dutch Childhood Cancer Survivor Study LATER cohort study includes 5-year childhood cancer survivors diagnosed View Article and Find Full Text PDF

Treatment-related survival patterns in diffuse intrinsic pontine glioma using a historical cohort: A report from the European Society for Pediatric Oncology DIPG/DMG Registry.

Background: Our aim is to investigate the association of treatment with survival in patients with diffuse intrinsic pontine glioma (DIPG) by examining 6 historical treatment paths.

Methods: We retrospectively analyzed data from 409 patients with radiologically centrally reviewed DIPG, sourced from the German Society of Pediatric Oncology and Hematology HIT-HGG trial database and the SIOPE-DIPG/DMG Registry. Survival outcomes were estimated using the Kaplan-Meier method, and univariable and multivariable Cox proportional hazard models were estimated to study treatment effects.

Navigated intraoperative ultrasound in pediatric brain tumors.

Purpose: The aim of this study was to evaluate the diagnostic value and accuracy of navigated intraoperative ultrasound (iUS) in pediatric oncological neurosurgery as compared to intraoperative magnetic resonance imaging (iMRI).

Methods: A total of 24 pediatric patients undergoing tumor debulking surgery with iUS, iMRI, and neuronavigation were included in this study. Prospective acquisition of iUS images was done at two time points during the surgical procedure: (1) before resection for tumor visualization and (2) after resection for residual tumor assessment.

Taenia martis Neurocysticercosis-Like Lesion in Child, Associated with Local Source, the Netherlands.

A neurocysticercosis-like lesion in an 11-year-old boy in the Netherlands was determined to be caused by the zoonotic Taenia martis tapeworm. Subsequent testing revealed that 15% of wild martens tested in that region were infected with T. martis tapeworms with 100% genetic similarity; thus, the infection source was most likely local.

Improving advanced intraoperative MRI methods during pediatric neurosurgery.

Advanced intraoperative MR images (ioMRI) acquired during the resection of pediatric brain tumors could offer additional physiological information to preserve healthy tissue. With this work, we aimed to develop a protocol for ioMRI with increased sensitivity for arterial spin labeling (ASL) and diffusion MRI (dMRI), optimized for patient positioning regularly used in the pediatric neurosurgery setting. For ethical reasons, ASL images were acquired in healthy adult subjects that were imaged in the prone and supine position.

Protocol for investigating data quality and reporting outcomes of pediatric gliomas in population-based cancer registry research.

Cancer registry data on pediatric gliomas come with inherent limitations as inclusion criteria and registration practices of these tumors differ between registries due to specific guidelines that are lacking. These limitations can lead to biased estimates in incidence and survival outcomes. Here, we present a protocol to investigate data quality and comparability for retrospective population-based pediatric glioma studies.

SMARCB1 loss activates patient-specific distal oncogenic enhancers in malignant rhabdoid tumors.

Malignant rhabdoid tumor (MRT) is a highly malignant and often lethal childhood cancer. MRTs are genetically defined by bi-allelic inactivating mutations in SMARCB1, a member of the BRG1/BRM-associated factors (BAF) chromatin remodeling complex. Mutations in BAF complex members are common in human cancer, yet their contribution to tumorigenesis remains in many cases poorly understood.

Microglia in pediatric brain tumors: The missing link to successful immunotherapy.

Brain tumors are the leading cause of cancer-related mortality in children. Despite the development of immunotherapeutic strategies for adult brain tumors, progress in pediatric neuro-oncology has been hindered by the complex and poorly understood nature of the brain's immune system during early development, a phase that is critical for the onset of many pediatric brain tumors. A defining characteristic of these tumors is the abundance of microglia, the resident immune cells of the central nervous system.