Quantification of Tumor Growth Kinetics in Patients Showing Progression From Low-grade to High-grade Gliomas

Background and aim: Gliomas are the most common primary brain tumors, and they are classified according to their histopathological and genetic features. Tumorigenesis depends on alterations in different genes. The aim of this study was to identify mutations in IDH1 and TERT genes in gliomas of Argentine patients and to correlate them with clinical features. Methods. DNA was isolated from 19 biopsies with different glioma grades matched with blood samples. IDH1 and TERT mutations were identified by PCR amplification and sequencing. Results. Six out of seven patients with low-grade glioma (grade II) harbor IDH1 mutations, mainly without tumor growth and an overall survival of more than 12 months. Eleven out of twelve patients with high-grade gliomas (grade III/IV) showed wild type IDH1, mainly with tumor growth and shorter survival than low-grade gliomas. Mutated TERT promoter was present in 5 out of 11 high-grade gliomas, showing the prevalence of polymorphic C allele, whereas, low-grade gliomas showed mutated TERT in 1 out of 5 gliomas and a predominance of T allele. TERT and IDH1 mutations were mutually exclusive in most gliomas. Conclusions: Our results show that genetic tests provided more accurate diagnosis than histopathological analysis. Evolution of gliomas can be predicted primarily by the mutational status of IDH1 and secondarily by other markers, such as TERT mutational status, and the patient´s age.

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The Added Value of Inflow-Based Vascular-Space-Occupancy and Diffusion-Weighted Imaging in Preoperative Grading of Gliomas

Neurodegenerative Diseases ◽

10.1159/000512545 ◽

2021 ◽

pp. 1-8

Author(s):

Haimei Cao ◽

Xiang Xiao ◽

Jun Hua ◽

Guanglong Huang ◽

Wenle He ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Roc Curve ◽

Diffusion Weighted Imaging ◽

Low Grade ◽

High Grade ◽

Mr Images ◽

Vascular Space ◽

Diffusion Weighted ◽

High Grade Gliomas ◽

And Diffusion

Objectives: The present study aimed to study whether combined inflow-based vascular-space-occupancy (iVASO) MR imaging (MRI) and diffusion-weighted imaging (DWI) improve the diagnostic accuracy in the preoperative grading of gliomas. Methods: Fifty-one patients with histopathologically confirmed diffuse gliomas underwent preoperative structural MRI, iVASO, and DWI. We performed 2 qualitative consensus reviews: (1) structural MR images alone and (2) structural MR images with iVASO and DWI. Relative arteriolar cerebral blood volume (rCBVa) and minimum apparent diffusion coefficient (mADC) were compared between low-grade and high-grade gliomas. Receiver operating characteristic (ROC) curve analysis was performed to compare the tumor grading efficiency of rCBVa, mADC, and the combination of the two parameters. Results: Two observers diagnosed accurate tumor grade in 40 of 51 (78.4%) patients in the first review and in 46 of 51 (90.2%) in the second review. Both rCBVa and mADC showed significant differences between low-grade and high-grade gliomas. ROC analysis gave a threshold value of 1.52 for rCBVa and 0.85 × 10−3 mm2/s for mADC to provide a sensitivity and specificity of 88.0 and 81.2% and 100.0 and 68.7%, respectively. The area under the ROC curve (AUC) was 0.87 and 0.85 for rCBVa and mADC, respectively. The combination of rCBVa and mADC values increased the AUC to 0.92. Conclusion: The combined application of iVASO and DWI may improve the diagnostic accuracy of glioma grading.

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