Mid-Treatment Magnetic Resonance Imaging in Pediatric Intracranial Low-Grade Gliomas Treated With Proton Beam Therapy

AbstractIntroduction: The treatment strategy for low-grade gliomas (LGGs) is still controversial, and there are no standardized criteria to predict the prognosis of patients with LGGs. Magnetic resonance imaging (MRI) is a routine test for preoperative diagnosis for LGG and can reflect the destructive features for the tumor. In the present study, we aimed to explore the relationship between the MRI features and prognosis in patients with LGG.Methods: Clinical data of 80 patients with pathologically proved LGGs between January 2010 and December 2016 were analyzed retrospectively. MRI features were classified as contrast enhancement pattern (focal enhancement, diffuse enhancement and ring-like enhancement), necrosis and cysts based on the preoperative MR images. Kaplan–Meier method and multivariate analysis were performed on the data by SPSS software to explore the prognostic significance of MRI features.Results: Patients with cystic LGG had a significantly longer 5-year progression-free survival (PFS) than that with no cyst (90.9 ± 8.7 vs 65.7 ± 9.1%, P=0.045). Multivariate analysis further verified cyst as an independent prognosis factor for PFS (P=0.027, hazard ratio [HR] = 0.084). Additionally, patients with ring-like enhancement exhibited significantly longer 5-year PFS time in the Kaplan–Meier survival curves (100 vs 67.2 ± 7.7%, P=0.049). There was no significant difference in PFS and overall survival (OS) between patients with or without necrosis.Conclusion: Our study suggests that cyst formation and ring-like enhancement on preoperative MR images can be useful to predict a favorable prognosis in patients with LGGs.

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Prediction of IDH Status Through MRI Features and Enlightened Reflection on the Delineation of Target Volume in Low-Grade Gliomas

Technology in Cancer Research & Treatment ◽

10.1177/1533033819877167 ◽

2019 ◽

Vol 18 ◽

pp. 153303381987716 ◽

Cited By ~ 4

Author(s):

Haixia Ding ◽

Yong Huang ◽

Zhiqiang Li ◽

Sirui Li ◽

Qiongrong Chen ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Isocitrate Dehydrogenase ◽

Target Volume ◽

Low Grade ◽

Creatinine Ratio ◽

Wild Type ◽

Resonance Imaging ◽

Low Grade Gliomas ◽

Mutational Status

Isocitrate dehydrogenase mutational status defines distinct biologic behavior and clinical outcomes in low-grade gliomas. We sought to determine magnetic resonance imaging characteristics associated with isocitrate dehydrogenase mutational status to evaluate the predictive roles of magnetic resonance imaging features in isocitrate dehydrogenase mutational status and therefore their potential impact on the determination of clinical target volume in radiotherapy. Forty-eight isocitrate dehydrogenase-mutant and 28 isocitrate dehydrogenase–wild-type low-grade gliomas were studied. Isocitrate dehydrogenase mutation was related to more frequency of cortical involvement compared to isocitrate dehydrogenase–wild-type group (34/46 vs 6/24, P = .0001). Peritumoral edema was less frequent in isocitrate dehydrogenase–mutant tumors (32.6% vs 58.3% for isocitrate dehydrogenase–wild-type tumors, P = .0381). Isocitrate dehydrogenase–wild-type tumors were more likely to have a nondefinable border, while isocitrate dehydrogenase–mutant tumors had well-defined borders (66.7% vs 39.1%, P = .0287). Only 8 (17.4%) of 46 of the isocitrate dehydrogenase–mutant tumors demonstrated marked enhancement, while this was 66.7% in isocitrate–wild-type tumors ( P < .0001). Choline–creatinine ratio for isocitrate dehydrogenase–wild-type tumors was significantly higher than that for isocitrate dehydrogenase–mutant tumors. In conclusion, frontal location, well-defined border, cortical involvement, less peritumoral edema, lack of enhancement, and low choline–creatinine ratio were predictive for the definition of isocitrate dehydrogenase–mutant low-grade gliomas. Magnetic resonance imaging can provide an advantage in the detection of isocitrate dehydrogenase status indirectly and indicate the need to explore new design for treatment planning in gliomas. Choline–creatinine ratio in magnetic resonance spectroscopy could be a potential more reasonable reference for the new design of delineation of target volume in low-grade gliomas.

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Automatic Classification and Segmentation of Low-Grade Gliomas in Magnetic Resonance Imaging

Proceedings of the Tenth International Conference on Soft Computing and Pattern Recognition (SoCPaR 2018) - Advances in Intelligent Systems and Computing ◽

10.1007/978-3-030-17065-3_5 ◽

2019 ◽

pp. 43-50

Author(s):

Marta Barbosa ◽

Pedro Moreira ◽

Rogério Ribeiro ◽

Luis Coelho

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Automatic Classification ◽

Low Grade ◽

Resonance Imaging ◽

Low Grade Gliomas

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Semi-automated segmentation of pre-operative low grade gliomas in magnetic resonance imaging

Cancer Imaging ◽

10.1186/s40644-015-0047-z ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 10

Author(s):

Zeynettin Akkus ◽

Jiri Sedlar ◽

Lucie Coufalova ◽

Panagiotis Korfiatis ◽

Timothy L. Kline ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Low Grade ◽

Automated Segmentation ◽

Resonance Imaging ◽

Low Grade Gliomas

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Diffusion-weighted magnetic resonance imaging and ultrasound evaluation of choroidal melanomas after proton-beam therapy

La radiologia medica ◽

10.1007/s11547-015-0509-1 ◽

2015 ◽

Vol 120 (7) ◽

pp. 634-640 ◽

Cited By ~ 5

Author(s):

Andrea Russo ◽

Cesare Mariotti ◽

Antonio Longo ◽

Pietro Valerio Foti ◽

Teresio Avitabile ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Proton Beam ◽

Proton Beam Therapy ◽

Resonance Imaging ◽

Diffusion Weighted ◽

Ultrasound Evaluation ◽

Weighted Magnetic Resonance Imaging ◽

Choroidal Melanomas

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Extension of diffuse low-grade gliomas beyond radiological borders as shown by the coregistration of histopathological and magnetic resonance imaging data

Journal of Neurosurgery ◽

10.3171/2015.10.jns15583 ◽

2016 ◽

Vol 125 (5) ◽

pp. 1155-1166 ◽

Cited By ~ 29

Author(s):

Maria Zetterling ◽

Kenney R Roodakker ◽

Shala Ghaderi Berntsson ◽

Per-Henrik Edqvist ◽

Francesco Latini ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

White Matter ◽

Magnetic Resonance ◽

Tumor Cells ◽

Tumor Invasion ◽

Low Grade ◽

Resonance Imaging ◽

En Bloc ◽

Low Grade Gliomas ◽

Idh1 R132h

OBJECTIVE Magnetic resonance imaging tends to underestimate the extent of diffuse low-grade gliomas (DLGGs). With the aim of studying the presence of tumor cells outside the radiological border, the authors developed a method of correlating MRI findings with histological data in patients with suspected DLGGs in whom en bloc resections were performed. METHODS Five patients with suspected DLGG suitable for en bloc resection were recruited from an ongoing prospective study. Sections of the entire tumor were immunostained with antibodies against mutated IDH1 protein (IDH1-R132H). Magnetic resonance images were coregistered with corresponding IDH1 images. The growth pattern of tumor cells in white and gray matter was assessed in comparison with signal changes on corresponding MRI slices. RESULTS Neuropathological assessment revealed DLGG in 4 patients and progression to WHO Grade III glioma in 1 patient. The tumor core consisted of a high density of IDH1-R132H–positive tumor cells and was located in both gray and white matter. Tumor cells infiltrated along the peripheral fibers of the white matter tracts. In all cases, tumor cells were found outside the radiological tumor border delineated on T2-FLAIR MRI sequences. CONCLUSIONS The authors present a new method for the coregistration of histological and radiological characteristics of en bloc–removed infiltrative brain tumors that discloses tumor invasion at the radiological tumor borders. This technique can be applied to evaluate the sensitivity of alternative imaging methods to detect scattered tumor cells at tumor borders. Accurate methods for detection of infiltrative tumor cells will improve the possibility of performing radical tumor resection. In future studies, the method could also be used for in vivo studies of tumor invasion.

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Cerebellar Tumor Extension as a Late Event of Long-standing, Supratentorial Low-grade Gliomas: Case Report

Neurosurgery ◽

10.1227/01.neu.0000215987.74391.8e ◽

2006 ◽

Vol 58 (6) ◽

pp. E1210-E1210 ◽

Cited By ~ 3

Author(s):

Jonathan Roth ◽

Dvora Nass ◽

Zvi Ram

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Young Patients ◽

Tumor Formation ◽

Low Grade ◽

Cerebellar Tumor ◽

Resonance Imaging ◽

Secondary Tumor ◽

Low Grade Gliomas ◽

Multicentric Tumor

Abstract OBJECTIVE AND IMPORTANCE: Nonpilocytic low-grade glial tumors in adults occur mostly in the supratentorial compartment. However, a few cases of infratentorial low-grade gliomas (LGG) have been described. The occurrence of LGG in the cerebellum in the setting of a previously existing supratentorial glioma is rare. CLINICAL PRESENTATION: We present three young patients with a histologically confirmed diagnosis of long-standing supratentorial LGG. All three patients presented years after their initial diagnosis with a second, nonenhancing lesion in the cerebellum, compatible with the radiological appearance of LGG. Two patients subsequently became symptomatic from these lesions and underwent surgical resection of the cerebellar lesions that were found to have similar pathological features to the original supratentorial tumors. This was confirmed by histology (both patients) and genetic markers (one patient). INTERVENTION: Magnetic resonance imaging did not demonstrate tumor continuity between the supratentorial and infratentorial lesions in any of the patients. The third patient has shown no cerebellar symptoms to date and is only followed with periodic magnetic resonance imaging. CONCLUSION: The anatomic/pathological basis of these rare cases may include a primary, multicentric tumor formation, or a secondary tumor infiltration of the cerebrocerebellar pathways, leading to the formation of the cerebellar tumor.

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