HG-104: MRI FINDINGS OF SHORT-TERM SURVIVORS OF DIFFUSE INTRINSIC PONTINE GLIOMA

From 2003 to 2016, we have treated 29 patients (age range 2-14 years 15 male:14 female) affected by diffuse intrinsic pontine glioma (DIPGs) in our centre at Bambino Gesù Children's Hospital. DIPG diagnosis was based on typical radiological and clinical features. MRI demonstrated a T1 hypointense and T2 hyperintense lesion, centred in and involving >50% of the pons, with absence of or irregular gadolinium enhancement. Our results reported 3 of the 29 cases showing an homogeneous peripherally enhancement of the lateral portion of the mass at onset; 1/3 with tumour infiltration extended anteriorly into the Meckel's cave at onset and leptomeningeal spread of disease within 2 months from diagnosis. Two of three demonstrated no leptomeningeal spread at onset and during follow-up (FUP); 3/3 demonstrated direct cranial nerves involvement (CNs) at MRI (2/3 trigeminal CN, 1/3 vestibulocochlear CN). Two of the 26 presented with leptomeningeal spread at 11 and 17 months of FUP; 1/26 were reported to involve the V CN with mass ring enhancement in the expected location of trigeminal nuclei. The patients with a progression-free survival (PFS) lower than 6 months presented peripherally enhancement and direct infiltration of cranial nerves (V and VIII CNs); 1 of these documented leptomeningeal spread at onset. They presented higher tendency to undergo dissemination than the remaining cases.