Prognostic significance of IDH mutation in adult low-grade gliomas: a meta-analysis

Brain tumors, such as low grade gliomas (LGG), are molecularly classified which require the surgical collection of tissue samples. The pre-surgical or non-operative identification of LGG molecular type could improve patient counseling and treatment decisions. However, radiographic approaches to LGG molecular classification are currently lacking, as clinicians are unable to reliably predict LGG molecular type using magnetic resonance imaging (MRI) studies. Machine learning approaches may improve the prediction of LGG molecular classification through MRI, however, the development of these techniques requires large annotated data sets. Merging clinical data from different hospitals to increase case numbers is needed, but the use of different scanners and settings can affect the results and simply combining them into a large dataset often have a significant negative impact on performance. This calls for efficient domain adaption methods. Despite some previous studies on domain adaptations, mapping MR images from different datasets to a common domain without affecting subtitle molecular-biomarker information has not been reported yet. In this paper, we propose an effective domain adaptation method based on Cycle Generative Adversarial Network (CycleGAN). The dataset is further enlarged by augmenting more MRIs using another GAN approach. Further, to tackle the issue of brain tumor segmentation that requires time and anatomical expertise to put exact boundary around the tumor, we have used a tight bounding box as a strategy. Finally, an efficient deep feature learning method, multi-stream convolutional autoencoder (CAE) and feature fusion, is proposed for the prediction of molecular subtypes (1p/19q-codeletion and IDH mutation). The experiments were conducted on a total of 161 patients consisting of FLAIR and T1 weighted with contrast enhanced (T1ce) MRIs from two different institutions in the USA and France. The proposed scheme is shown to achieve the test accuracy of 74 . 81 % on 1p/19q codeletion and 81 . 19 % on IDH mutation, with marked improvement over the results obtained without domain mapping. This approach is also shown to have comparable performance to several state-of-the-art methods.

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Prognostic significance of contrast-enhancing low-grade gliomas in adults and a review of the literature

Neurological Research ◽

10.1179/174313209x395454 ◽

2009 ◽

Vol 31 (9) ◽

pp. 931-939 ◽

Cited By ~ 40

Author(s):

Kaisorn L. Chaichana ◽

Matthew J. McGirt ◽

Ashwini Niranjan ◽

Alessandro Olivi ◽

Peter C. Burger ◽

...

Keyword(s):

Prognostic Significance ◽

Low Grade ◽

Review Of The Literature ◽

Low Grade Gliomas

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Management of low-grade glioma: a systematic review and meta-analysis

Neuro-Oncology Practice ◽

10.1093/nop/npy034 ◽

2018 ◽

Vol 6 (4) ◽

pp. 249-258 ◽

Cited By ~ 7

Author(s):

Timothy J Brown ◽

Daniela A Bota ◽

Martin J van Den Bent ◽

Paul D Brown ◽

Elizabeth Maher ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Progression Free Survival ◽

Low Grade Glioma ◽

World Health ◽

Subtotal Resection ◽

Low Grade ◽

Evidence Based ◽

Free Survival ◽

Low Grade Gliomas

Abstract Background Optimum management of low-grade gliomas remains controversial, and widespread practice variation exists. This evidence-based meta-analysis evaluates the association of extent of resection, radiation, and chemotherapy with mortality and progression-free survival at 2, 5, and 10 years in patients with low-grade glioma. Methods A quantitative systematic review was performed. Inclusion criteria included controlled trials of newly diagnosed low-grade (World Health Organization Grades I and II) gliomas in adults. Eligible studies were identified, assigned a level of evidence for every endpoint considered, and analyzed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The relative risk of mortality and of progression at 2, 5, and 10 years was calculated for patients undergoing resection (gross total, subtotal, or biopsy), radiation, or chemotherapy. Results Gross total resection was significantly associated with decreased mortality and likelihood of progression at all time points compared to subtotal resection. Early radiation was not associated with decreased mortality; however, progression-free survival was better at 5 years compared to patients receiving delayed or no radiation. Chemotherapy was associated with decreased mortality at 5 and 10 years in the high-quality literature. Progression-free survival was better at 5 and 10 years compared to patients who did not receive chemotherapy. In patients with isocitrate dehydrogenase 1 gene (IDH1) R132H mutations receiving chemotherapy, progression-free survival was better at 2 and 5 years than in patients with IDH1 wild-type gliomas. Conclusions Results from this review, the first to quantify differences in outcome associated with surgery, radiation, and chemotherapy in patients with low-grade gliomas, can be used to inform evidence-based management and future clinical trials.

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P10.21 2-hydroxyglutarate as a biomarker for IDH mutation in low grade gliomas

Neuro-Oncology ◽

10.1093/neuonc/nox036.339 ◽

2017 ◽

Vol 19 (suppl_3) ◽

pp. iii89-iii90

Author(s):

R. Nejad ◽

H. Sim ◽

K. Aldape ◽

W. Mason ◽

M. Bernstein ◽

...

Keyword(s):

Low Grade ◽

Idh Mutation ◽

Low Grade Gliomas

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IDH mutation and 1p19q codeletion distinguish two radiological patterns of diffuse low-grade gliomas

Journal of Neuro-Oncology ◽

10.1007/s11060-017-2421-0 ◽

2017 ◽

Vol 133 (1) ◽

pp. 37-45 ◽

Cited By ~ 29

Author(s):

Amélie Darlix ◽

Jérémy Deverdun ◽

Nicolas Menjot de Champfleur ◽

Florence Castan ◽

Sonia Zouaoui ◽

...

Keyword(s):

Low Grade ◽

Idh Mutation ◽

Low Grade Gliomas ◽

1P19q Codeletion ◽

Radiological Patterns

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Prognostic significance of clinical parameters in patients with cerebral low-grade glioma

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh200513085j ◽

2020 ◽

pp. 85-85

Author(s):

Milos Jokovic ◽

Radovan Mijalcic ◽

Vladimir Bascarevic ◽

Nemanja Jovanovic

Keyword(s):

Overall Survival ◽

Tumor Biology ◽

Prognostic Significance ◽

Extent Of Resection ◽

Categorical Variables ◽

Low Grade ◽

Clinical Parameters ◽

Site Location ◽

Who Grade ◽

Low Grade Gliomas

Introduction/Objective. Low-grade gliomas (LGG) affect younger adults and carry a favorable prognosis. We aim to describe clinical patterns of low-grade gliomas as well as prognosis in different groups of patients. Our intention was to determine clinical parameters that may affect prognosis, and whether a greater extent of resection would increase the long-term progression-free or overall survival of patients with low-grade gliomas. Methods. We analyzed data obtained from the files of the patients with a diagnosis of WHO grade II gliomas. The relationships among categorical variables were analyzed using standard statistical tools and a 95% confidence interval (CI). Results. We analyzed 118 patients with median age of 34 years. Over 57% were male and the primary site location was the cerebrum. All these patients were operated on and some of them received radiation and/or chemotherapy. Median overall survival was 9.6 years and better prognosis is associated with younger age, frontal and noneloquent zone location, seizures as the first symptom of disease and gross total resection of the tumor. Indications for early surgery are increased intracranial pressure, preoperative neurologic deficit, tumor size larger than 6 cm with contrast enhancement and older age. Conclusion. Tumor location, 1p/19q co-deletion and age were the main determinants of treatment received and overall survival, likely reflecting tumor biology differences. Any form of treatment was preferred over watchful waiting. This study found that a greater extent of resection could significantly increase the overall survival of patients with low-grade gliomas.

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Pharmacoresistant seizures and IDH mutation in low grade gliomas

Neuro-Oncology Advances ◽

10.1093/noajnl/vdab146 ◽

2021 ◽

Author(s):

Carlos Eduardo Correia ◽

Yoshie Umemura ◽

Jessica R Flynn ◽

Anne S Reiner ◽

Edward K Avila

Keyword(s):

Tumor Resection ◽

Incidence Rates ◽

P Value ◽

Low Grade ◽

Idh Mutation ◽

Wild Type ◽

Mutation Status ◽

Low Grade Gliomas ◽

Idh1 R132h ◽

Idh Mutations

Abstract Purpose Many low-grade gliomas (LGG) harbor isocitrate dehydrogenase (IDH) mutations. Although IDH mutation is known to be epileptogenic, the rate of refractory seizures in LGG with IDH mutation vs wild-type had not been previously compared. We therefore compared seizure pharmacoresistance in IDH-mutated and wild-type LGGs. Methods Single-institution retrospective study of patients with histologic proven LGG, known IDH mutation status, seizures, and ≥ 2 neurology clinic encounters. Seizure history was followed until histological high-grade transformation or death. Seizures requiring ≥ 2 changes in anti-epileptic drugs were considered pharmacoresistant. Incidence rates of pharmacoresistant seizures were estimated using competing risks methodology. Results Of 135 patients, 25 patients (19%) had LGGs classified as IDH wild-type. Of those with IDH mutation, 104 (94.5%) were IDH1 R132H; only six were IDH2 R172K. 120 patients (89%) had tumor resection and 14 (10%) had biopsy. Initial post-surgical management included observation (64%), concurrent chemoradiation (23%), chemotherapy alone (9%), and radiotherapy alone (4%). Seizures became pharmacoresistant in 24 IDH-mutated patients (22%) and in 3 IDH wild-type patients (12%). The 4-year cumulative incidence of intractable seizures was 17.6% (95% CI: 10.6%-25.9%) in IDH-mutated and 11% (95% CI: 1.3%-32.6%) in IDH wild-type LGG (Gray’s P-value= 0.26). Conclusions 22% of the IDH-mutated patients developed pharmacoresistant seizures, compared to 12% of the IDH wild-type tumors.The likelihood of developing pharmacoresistant seizures in patients with LGG-related epilepsy is independent to IDH mutation status, however, IDH-mutated tumors were approximately twice as likely to experience LGG-related pharmacoresistant seizures.

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