Role of Arterial Spin Labelling Magnetic Resonance Prefusion in Grading of Pediatric Brain Tumors
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- This is an observational study: the protocol does not assign a study treatment.
- Who it may be relevant to
- Registry conditions: Pediatric Brain Tumors. Basic parameters: 0 years — 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Role of Arterial Spin Labelling Magnetic Resonance Perfusion in The Grading of Pediatric Brain Tumors
Overview
To evaluate the diagnostic performance of arterial spin labelling (ASL) magnetic resonance perfusion in preoperative grading of pediatric brain tumors.
Detailed description
Pediatric brain tumors are one of the most common malignancies in children and represent a leading cause of cancer-related morbidity and mortality worldwide. Accurate preoperative tumor grading plays a pivotal role in determining treatment strategies, surgical planning, prognosis and long-term follow-up. Histopathological grading remains the reference standard; however, non-invasive imaging capable of predicting tumor grade preoperatively are increasingly sought to optimize patient management.
Conventional magnetic resonance imaging (MRI) provides excellent anatomical resolution and lesion localization; nevertheless, substantial overlap persists in morphological imaging features between low-grade and high-grade pediatric brain tumors. In children, contrast enhancement does not correlate with tumor grade, unlike the way it does in adults. Diffusion parameters overlap between benign and aggressive lesions as well, limiting the accuracy of conventional MRI in reliable tumor grading when used alone.
Advanced MRI techniques, particularly perfusion imaging, have emerged as valuable adjuncts for tumor characterization by evaluating tumor vascularity and microcirculation. Arterial spin labelling (ASL) is a non-contrast perfusion MRI technique that quantifies cerebral blood flow (CBF) using magnetically labeled arterial blood water as an endogenous tracer. This technique is especially advantageous in the pediatric population, as it eliminates exposure to gadolinium-based contrast agents and avoids ionizing radiation, aligning with current safety recommendations in children.
High-grade pediatric brain tumors typically demonstrate increased angiogenesis, microvascular proliferation and elevated perfusion compared with low-grade tumors. Recent studies have shown that ASL-derived perfusion parameters correlate with tumor grade and histopathological aggressiveness in pediatric brain tumors.
Despite growing evidence supporting its diagnostic value, arterial spin labelling (ASL) remains underutilized in routine clinical practice for pediatric brain tumor grading. Further prospective studies are required to validate its diagnostic performance and establish its role as a reliable non-invasive imaging biomarker.
Primary outcome measures
- Evaluate the diagnostic value of arterial spin labelling (ASL) magnetic resonance perfusion in pre-operative grading of pediatric brain tumors [Time frame: preoperative]
Eligibility criteria
Inclusion criteria
- Pediatric patients aged 18 years or younger.
- Patients with radiological diagnosis of intracranial brain tumors.
Exclusion criteria
- Patients who have received prior surgery, chemotherapy or radiotherapy for brain tumors.
- Patients with contraindications to magnetic resonance imaging (MRI) examination.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Cohort
Study locations
Center list to be confirmed — check the primary protocol.
Publications
- Kong L, Chen H, Yang Y, Chen L. A meta-analysis of arterial spin labelling perfusion values for the prediction of glioma grade. Clin Radiol. 2017 Mar;72(3):255-261. doi: 10.1016/j.crad.2016.10.016. Epub 2016 Dec 6. PMID 27932251
- Morana G, Tortora D, Stagliano S, Nozza P, Mascelli S, Severino M, Piatelli G, Consales A, Lequin M, Garre ML, Rossi A. Pediatric astrocytic tumor grading: comparison between arterial spin labeling and dynamic susceptibility contrast MRI perfusion. Neuroradiology. 2018 Apr;60(4):437-446. doi: 10.1007/s00234-018-1992-6. Epub 2018 Feb 16. PMID 29453753
- Dangouloff-Ros V, Deroulers C, Foissac F, Badoual M, Shotar E, Grevent D, Calmon R, Pages M, Grill J, Dufour C, Blauwblomme T, Puget S, Zerah M, Sainte-Rose C, Brunelle F, Varlet P, Boddaert N. Arterial Spin Labeling to Predict Brain Tumor Grading in Children: Correlations between Histopathologic Vascular Density and Perfusion MR Imaging. Radiology. 2016 Nov;281(2):553-566. doi: 10.1148/radiol.201 PMID 27257950
- Furtner J, Schopf V, Schewzow K, Kasprian G, Weber M, Woitek R, Asenbaum U, Preusser M, Marosi C, Hainfellner JA, Widhalm G, Wolfsberger S, Prayer D. Arterial spin-labeling assessment of normalized vascular intratumoral signal intensity as a predictor of histologic grade of astrocytic neoplasms. AJNR Am J Neuroradiol. 2014 Mar;35(3):482-9. doi: 10.3174/ajnr.A3705. Epub 2013 Aug 14. PMID 23945226
- Yeom KW, Mitchell LA, Lober RM, Barnes PD, Vogel H, Fisher PG, Edwards MS. Arterial spin-labeled perfusion of pediatric brain tumors. AJNR Am J Neuroradiol. 2014 Feb;35(2):395-401. doi: 10.3174/ajnr.A3670. Epub 2013 Aug 1. PMID 23907239
Identifiers
NCT: NCT07427316 · ASLMRI