Medulloblastoma Radiographic Features

Medulloblastoma Classification presents many faces in medical imaging.

Location is the key to this approach

cerebellar peduncle/foramen of Luschka

very likely Medulloblastoma, WNT-activated and therefore best prognosis

cerebellar hemisphere

very likely SHH subgroup and therefore intermediate prognosis likely desmoplastic/nodular/medulloblastoma with extensive nodularity (MBEN)

midline

may be Group 3 medulloblastoma, Group 4 medulloblastoma or Medulloblastoma, SHH-activated

typically infants with a tumor with ill-defined margins but prominent enhancement: likely Group 3 medulloblastoma or Medulloblastoma, SHH-activated and therefore worst prognosis

typically children with a tumor with well-defined margins but mild or no enhancement: likely Group 4 medulloblastoma and therefore slightly better prognosis

adults with variably defined and variably enhancing tumors: most likely Medulloblastoma, SHH-activated; hemorrhage raises the probability of group 1)


1)
Keil VC, Warmuth-Metz M, Reh C, Enkirch SJ, Reinert C, Beier D, Jones DTW, Pietsch T, Schild HH, Hattingen E, Hau P. Imaging Biomarkers for Adult Medulloblastomas: Genetic Entities May Be Identified by Their MR Imaging Radiophenotype. AJNR Am J Neuroradiol. 2017 Oct;38(10):1892-1898. doi: 10.3174/ajnr.A5313. Epub 2017 Aug 10. PMID: 28798218; PMCID: PMC7963605.
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