Association of Dynamic Susceptibility Magnetic Resonance Imaging at Initial Tumor Diagnosis with the Prognosis of Different Molecular Glioma Subtypes

Overview

Journal Neurol Sci

Specialty Neurology

Date 2020 May 29

PMID 32462389

Citations 4

Authors

Cornelia Brendle

Uwe Klose

Johann-Martin Hempel

Jens Schittenhelm

Marco Skardelly

Ghazaleh Tabatabai

Ulrike Ernemann

Benjamin Bender

Affiliations

Soon will be listed here.

Abstract

Purpose: The updated 2016 CNS World Health Organization classification differentiates three main groups of diffuse glioma according to their molecular characteristics: astrocytic tumors with and without isocitrate dehydrogenase (IDH) mutation and 1p/19q co-deleted oligodendrogliomas. The present study aimed to determine whether dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) is an independent prognostic marker within the molecular subgroups of diffuse glioma.

Methods: Fifty-six patients with treatment-naive gliomas and advanced preoperative MRI examination were assessed retrospectively. The mean and maximal normalized cerebral blood volume values from DSC-MRI within the tumors were measured. Optimal cutoff values for the 1-year progression-free survival (PFS) were defined, and Kaplan-Meier analyses were performed separately for the three glioma subgroups.

Results: IDH wild-type astrocytic tumors had a higher mean and maximal perfusion than IDH-mutant astrocytic tumors and oligodendrogliomas. Patients with IDH wild-type astrocytic tumors and a low mean or maximal perfusion had a significantly shorter PFS than patients of the same group with high perfusion (p = 0.0159/0.0112). Furthermore, they had a significantly higher risk for early progression (hazard ratio = 5.6/5.1). This finding was independent of the methylation status of O6-methylguanin-DNA-methyltransferase and variations of the therapy. Within the groups of IDH-mutant astrocytic tumors and oligodendrogliomas, the PFS of low and highly perfused tumors did not differ.

Conclusion: High perfusion upon initial diagnosis is not compellingly associated with worse short-term prognosis within the different molecular subgroups of diffuse glioma. Particularly, the overall highly perfused group of IDH wild-type astrocytic tumors contains tumors with low perfusion but unfavorable prognosis.

Citing Articles

The role of DSC MR perfusion in predicting IDH mutation and 1p19q codeletion status in gliomas: meta-analysis and technical considerations.

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A systematic review and meta-analysis on the differentiation of glioma grade and mutational status by use of perfusion-based magnetic resonance imaging.

van Santwijk L, Kouwenberg V, Meijer F, Smits M, Henssen D Insights Imaging. 2022; 13(1):102.

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ADC-Based Stratification of Molecular Glioma Subtypes Using High b-Value Diffusion-Weighted Imaging.

Nuessle N, Behling F, Tabatabai G, Vega S, Schittenhelm J, Ernemann U J Clin Med. 2021; 10(16).

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Clonal evolution and supratentorial dissemination of a spinal cord glioma.

Kong Z, Chen W, Zhao D, Wang Y, Ma W Neurol Sci. 2020; 42(5):2137-2141.

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