Cortical mapping provide insights into whole-brain tumor burden in diffuse midline glioma

Motivation: Diffuse midline glioma (DMG) represents a systemic disease due to its ability to disseminate tumor cells throughout the whole brain. Current imaging techniques, however, provide information only about the main tumor and its immediate surroundings. Goal(s): We employed comprehensive cortical mapping to gain insights into the individual tumor burden across whole-brain using structural MRI. Approach: Cortical thickness and myelin content was calculated from participants using Human Connectome Project pipeline. Results: DMG has the capacity to induce cortical thickness compensation while concurrently leading to cortical demyelination in numerous non-lesional regions. Notably, DMG harboring H3K27M altered exhibited specific cortical myelin and thickness reorganization patterns. Impact: These findings may open up the possibility of tailoring treatment strategies to the individual disease severity and distribution within the patient's brain, potentially enhancing the effectiveness of both current and future treatment approaches.