Malbari F, Chintagumpala MM, Wood AC, et al. - The purpose of this study is to evaluate whether MRI with gadolinium-based contrast agents (GBCA) is necessary for determining radiographic tumor progression in children with chiasmatic-hypothalamic low-grade glioma (CHLGG). Between 2005 and 2019, children who were treated for progressive CHLGG at Texas Children's Cancer Center were distinguished. Researchers separately reviewed pre- and post-contrast MRI sequences by one neuroradiologist who was blinded to the clinical course. They distinguished a total of 28 patients with progressive CHLGG with a total of 683 MRIs with GBCA reviewed (mean 24 MRIs/patient; range, 11-43 MRIs). MRI without GBCA effectively distinguishes individuals with progressive disease. Eliminating GBCA should be considered unless monitoring patients with metastatic disease, when imaging children with CHLGG.