{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:44:05Z","timestamp":1789991045968,"version":"4.0.1"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2014]]},"abstract":"<jats:p><jats:italic>Purpose<\/jats:italic>. To evaluate tumor structure in children with diffuse intrinsic pontine glioma (DIPG) using histogram analyses of mean diffusivity (MD), determine potential treatment and corticosteroid-related effects on MD, and monitor changes in MD distributions over time.<jats:italic>Materials and Methods<\/jats:italic>. DTI was performed on a 1.5T GE scanner. Regions of interest included the entire FLAIR-defined tumor. MD data were used to calculate histograms. Patterns in MD distributions were evaluated and fitted using a two-normal mixture model. Treatment-related effects were evaluated using the<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mrow><mml:msup><mml:mrow><mml:mi>R<\/mml:mi><\/mml:mrow><mml:mrow><mml:mn>2<\/mml:mn><\/mml:mrow><\/mml:msup><\/mml:mrow><\/mml:math>statistic for linear mixed models and Cox proportional hazards models.<jats:italic>Results<\/jats:italic>. 12 patients with DIPG underwent one or more DTI exams. MD histogram distributions varied among patients. Over time, histogram peaks became shorter and broader (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.0443<\/mml:mn><\/mml:math>). Two-normal mixture fitting revealed large lower curve proportions that were not associated with treatment response or outcome. Corticosteroid use affected MD histograms and was strongly associated with larger, sharper peaks (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:msup><mml:mrow><mml:mi>R<\/mml:mi><\/mml:mrow><mml:mrow><mml:mn>2<\/mml:mn><\/mml:mrow><\/mml:msup><mml:mo>=<\/mml:mo><mml:mn>0.51<\/mml:mn><\/mml:math>,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.0028<\/mml:mn><\/mml:math>).<jats:italic>Conclusions<\/jats:italic>. MD histograms of pediatric DIPG show significant interpatient and intratumoral differences and quantifiable changes in tumor structure over time. Corticosteroids greatly affected MD and must be considered a confounding factor when interpreting MD results in the context of treatment response.<\/jats:p>","DOI":"10.1155\/2014\/647356","type":"journal-article","created":{"date-parts":[[2014,6,11]],"date-time":"2014-06-11T17:25:49Z","timestamp":1402507549000},"page":"1-9","source":"Crossref","is-referenced-by-count":11,"title":["Diffusion Tensor Histogram Analysis of Pediatric Diffuse Intrinsic Pontine Glioma"],"prefix":"10.1155","volume":"2014","author":[{"given":"Emilie A.","family":"Steffen-Smith","sequence":"first","affiliation":[{"name":"Pediatric Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institutes of Health, Building 10, Room 1-5750, 9000 Rockville Pike, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joelle E.","family":"Sarlls","sequence":"additional","affiliation":[{"name":"In Vivo NMR Center, National Institute of Neurological Disorders and Stroke, National Institutes of the Health, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Pierpaoli","sequence":"additional","affiliation":[{"name":"Program on Pediatric Imaging and Tissue Sciences, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna H.","family":"Shih","sequence":"additional","affiliation":[{"name":"Biostatistics and Data Management Section, National Cancer Institute, Center for Cancer Research, National Institutes of the Health, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn S.","family":"Bent","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institutes of Health, Building 10, Room 1-5750, 9000 Rockville Pike, Bethesda, MD 20892, 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