MRI scan highlighting ATRT tumor subtypes.

Decoding Brain Tumors: How MRI Can Spot Subtypes of ATRT

Elliot Brynn in Health & Wellness December 2025 • 4 min read.

"New research reveals that MRI scans can help identify molecular subgroups of atypical teratoid/rhabdoid tumors (ATRT), leading to better diagnoses and targeted treatments."

Atypical teratoid/rhabdoid tumors (ATRT) are rare and aggressive brain tumors that primarily affect young children. Making up only 1-2% of all pediatric brain tumors, they can account for up to 20% of brain tumor cases in children under three years old. These tumors are known for their rapid growth and resistance to conventional treatments, making early and accurate diagnosis critical.

Recent advances in molecular biology have identified three distinct subgroups of ATRT: SHH, TYR, and MYC. Each subgroup has unique genetic and epigenetic characteristics, leading to variations in their behavior and response to therapy. Understanding these molecular differences is crucial for developing targeted treatments that can improve patient outcomes.

Magnetic resonance imaging (MRI) is a powerful tool for visualizing brain tumors and assessing their characteristics. While MRI can detect ATRT, distinguishing between the molecular subgroups has been challenging. However, a new study reveals that specific MRI features can serve as surrogates for these subgroups, providing valuable information for diagnosis and treatment planning.

MRI: A Window into ATRT Subtypes

MRI scan highlighting ATRT tumor subtypes.

Researchers analyzed MRI scans from 43 patients with known ATRT molecular subgroup status. They looked for patterns in tumor location, peritumoral edema (swelling around the tumor), the presence of cysts, contrast enhancement, and other imaging features. The goal was to identify MRI characteristics that correlated with each of the three ATRT subgroups.

The study revealed significant differences in MRI features between the ATRT subgroups:

ATRT-TYR: Primarily located in the infratentorial region (lower part of the brain)
ATRT-MYC: Often showed more peritumoral edema (swelling) compared to other subgroups.
ATRT-SHH: More frequently exhibited peripheral tumor cysts (fluid-filled sacs around the tumor). Contrast enhancement (how the tumor appears after injecting a contrast dye) was less common in this subgroup.

These findings suggest that MRI can be used as a non-invasive tool to predict the molecular subgroup of ATRT. This information can help doctors make more informed decisions about treatment strategies.

The Future of ATRT Diagnosis and Treatment

This study provides a foundation for using MRI as a surrogate marker for ATRT molecular subgroups. By identifying specific MRI features associated with each subgroup, doctors can gain valuable insights into the tumor's behavior and potential response to therapy.

The ability to differentiate ATRT subgroups based on MRI could lead to more personalized treatment strategies. For example, patients with ATRT-MYC tumors, which tend to have more edema, might benefit from therapies that target edema formation. Similarly, patients with ATRT-SHH tumors, which are less likely to show contrast enhancement, might require different imaging techniques to monitor treatment response.

While these findings are promising, further research is needed to validate the use of MRI as a surrogate marker for ATRT subgroups. Future prospective trials should incorporate MRI analysis to assess its accuracy and impact on treatment outcomes. Ultimately, this research could lead to improved diagnosis, treatment, and survival for children with ATRT.

About this Article -

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This article is based on research published under:

DOI-LINK: 10.1093/neuonc/noy111, Alternate LINK

Title: Magnetic Resonance Imaging Surrogates Of Molecular Subgroups In Atypical Teratoid/Rhabdoid Tumor

Subject: Cancer Research

Journal: Neuro-Oncology

Publisher: Oxford University Press (OUP)

Authors: Johannes Nowak, Karolina Nemes, Annika Hohm, Lindsey A Vandergrift, Martin Hasselblatt, Pascal D Johann, Marcel Kool, Michael C Frühwald, Monika Warmuth-Metz

Published: 2018-07-13

Everything You Need To Know

What are Atypical teratoid/rhabdoid tumors (ATRT), and why are they significant?

Atypical teratoid/rhabdoid tumors (ATRT) are rare and aggressive brain tumors that primarily affect young children, accounting for a small percentage of all pediatric brain tumors. They are significant because of their rapid growth and resistance to conventional treatments. The implications of these tumors include the need for early and accurate diagnosis to improve patient outcomes.

How is Magnetic resonance imaging (MRI) used in relation to Atypical teratoid/rhabdoid tumors (ATRT)?

Magnetic resonance imaging (MRI) is a powerful imaging technique used to visualize brain tumors. While MRI can detect the presence of Atypical teratoid/rhabdoid tumors (ATRT), this study reveals that specific MRI features can serve as surrogates for the molecular subgroups, providing valuable information for diagnosis and treatment planning. MRI's significance lies in its non-invasive nature, allowing doctors to gain insights into the tumor's characteristics without the need for invasive procedures.

What are the different molecular subgroups of Atypical teratoid/rhabdoid tumors (ATRT), and why is it important to know them?

The molecular subgroups of Atypical teratoid/rhabdoid tumors (ATRT) are SHH, TYR, and MYC. Each subgroup has unique genetic and epigenetic characteristics, influencing its behavior and response to therapy. Understanding these differences is critical for developing targeted treatments. Identifying these subgroups through imaging allows doctors to tailor treatments to the specific characteristics of the tumor, potentially leading to improved patient outcomes. For example, ATRT-TYR are primarily located in the infratentorial region, ATRT-MYC often shows more peritumoral edema, and ATRT-SHH more frequently exhibits peripheral tumor cysts.

How can MRI scans help to identify the different subtypes of Atypical teratoid/rhabdoid tumors (ATRT)?

MRI can help identify the subtypes of Atypical teratoid/rhabdoid tumors (ATRT) by looking at specific features within the scan. Research has shown that MRI features correlate with the three subgroups of ATRT. For instance, the location of the tumor, the presence of peritumoral edema, cysts, and contrast enhancement can help distinguish between ATRT-SHH, ATRT-TYR, and ATRT-MYC. This information allows doctors to make more informed decisions about treatment strategies, because the subgroups have different characteristics and respond differently to treatments.

What are the implications of this research on MRI findings and Atypical teratoid/rhabdoid tumors (ATRT) for the future?

The findings on MRI and Atypical teratoid/rhabdoid tumors (ATRT) are important because they offer a non-invasive method for predicting the molecular subgroup of ATRT. This can guide treatment decisions, offering hope for more personalized and effective therapies. The implications include the potential for earlier and more accurate diagnoses, leading to improved patient outcomes and the development of targeted treatments that are tailored to the specific characteristics of each ATRT subgroup. This work provides a foundation for future diagnostic advancements.