Limited research investigating the value of MRI in predicting future cognitive morbidity in survivors of paediatric brain tumours: A systematic-review and call to action for clinical neuroimaging researchers

Abstract

Survivors of pediatric brain tumours are at a high risk of cognitive morbidity. Reliable individual-level predictions regarding the likelihood, degree, and affected domains of cognitive impairment would be clinically beneficial. While established risk factors exist, quantitative MRI analysis may enhance predictive value, above and beyond current clinical risk models. This systematic review addresses the question: “Do MRI markers predict future cognitive functioning in pediatric brain tumour survivors?” We conducted a comprehensive search for studies published up to March 2024 that assessed MRI variables as predictors of later neuropsychological outcomes in pediatric brain tumour patients. Only studies that acquired MRI scans at an earlier timepoint to predict subsequent cognitive test performance were included. Surprisingly, few studies met these criteria, with identified research focusing primarily on MRI measures of cerebellar and white matter damage as features in predicting cognitive outcomes. Ultimately, this review reveals a limited literature, characterized by small sample sizes and poor-quality studies, placing findings at high risk of bias. Consequently, the quality and conclusions drawn from the existing research are constrained, especially in the context of prediction studies. Given the significant implications for this clinical population, this review highlights the urgent need for further investigation and a ‘call to action’ for medical imaging researchers in pediatric neuro-oncology.

Publication DOI: https://doi.org/10.1371/journal.pone.0314721
Divisions: College of Health & Life Sciences > Aston Institute of Health & Neurodevelopment (AIHN)
College of Health & Life Sciences
College of Health & Life Sciences > School of Psychology
Funding Information: DGK is funded by a post-doctoral award from Aston University College of Health and Life Sciences, awarded to JN & DGK. The funder played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Additional Information: Copyright © 2025 Griffiths-King et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Uncontrolled Keywords: Brain Neoplasms/diagnostic imaging,Cancer Survivors/psychology,Child,Cognition,Cognitive Dysfunction/diagnostic imaging,Humans,Magnetic Resonance Imaging/methods,Neuroimaging/methods
Publication ISSN: 1932-6203
Data Access Statement: No datasets were generated or analysed during the current study. Data extracted from included studies is publicly available and found (in its entirety) in Table 2. All relevant data are within the manuscript.
Last Modified: 26 Mar 2025 17:42
Date Deposited: 31 Jan 2025 11:04
Full Text Link:
Related URLs: https://journal ... al.pone.0314721 (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Review article
Published Date: 2025-01-30
Published Online Date: 2025-01-30
Accepted Date: 2024-11-14
Authors: Griffiths-King, Daniel J. (ORCID Profile 0000-0001-5797-9203)
Delivett, Christopher
Peet, Andrew
Waite, Jane (ORCID Profile 0000-0002-8676-3070)
Novak, Jan (ORCID Profile 0000-0001-5173-3608)

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