On The Horizon for Intramedullary Spinal Cord Tumors in Children

  • Improving pathological classification: A call has been made for a central pathological review of IMSCT specimens housed at centers where a significant number of surgeries for IMSCTs have occurred (7). Tumors are named or classified in order to predict their behavior and guide the treatment(s) delivered to them. IMSCTs have unique biologies that differ from brain tumors,  but the classification system developed for brain tumors is used to classify IMSCTs.
  • Improving tumor imaging: Diffusion tensor (DT) imaging might be a useful tool to differentiate infiltrating from non-infiltrating IMSCTs (40). While there has been no proof that surgery is beneficial for patients harboring malignant IMSCTs, current MRI is not able to unequivocally differentiate malignant from nonmalignant IMSCTs (41).  Malignant IMSCTs are much more infiltrative than nonmalignant ones, so theoretically fiber tracts should be maintained on DT imaging with nonmalignant tumors and lost with malignant tumors.