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

2019 ◽  
Vol 18 ◽  
pp. 153303381987716 ◽  
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.

scholarly journals Prognostic value of magnetic resonance imaging features in low-grade gliomas

2019 ◽  
Vol 39 (6) ◽  
Author(s):  
Liang Deng ◽  
Liangfang Shen ◽  
Lin Shen ◽  
Zhao Zhao ◽  
Yingpeng Peng ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multivariate Analysis ◽  
Magnetic Resonance ◽  
Low Grade ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Mr Images ◽  
Low Grade Gliomas ◽  
Kaplan Meier ◽  
Mri Features

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.

scholarly journals Magnetic Resonance Imaging Derived Biomarkers of IDH Mutation Status and Overall Survival in Grade III Astrocytomas

Diagnostics ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 247
Author(s):  
Paola Feraco ◽  
Antonella Bacci ◽  
Patrizia Ferrazza ◽  
Luc van den Hauwe ◽  
Riccardo Pertile ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Overall Survival ◽  
Magnetic Resonance ◽  
Idh Mutation ◽  
Wild Type ◽  
Resonance Imaging ◽  
Characteristic Analysis ◽  
Mutation Status ◽  
Mutational Status ◽  
Adc Values

The evaluation of the isocitrate dehydrogenase (IDH) mutation status in the glioma decision-making process has diagnostic, prognostic and therapeutic implications. The aim of this study was to evaluate whether conventional magnetic resonance imaging (MRI) and apparent diffusion coefficient (ADC) can noninvasively predict the most common IDH mutational status (R132H) in GIII-astrocytomas and the overall survival (OS). Hence, twenty-two patients (9-F, 13-M) with a histological diagnosis of GIII-astrocytoma and evaluation of IDH-mutation status (12-wild type, 10-mutant) were retrospectively evaluated. Imaging studies were reviewed for the morphological feature and mean ADC values (ADCm). Statistics included a Fisher’s exact test, Student’s t-test, Spearman’s Test and receiver operating characteristic analysis. A p ≤ 0.05 value was considered statistically significant for all the tests. A younger age and a frontal location were more likely related to mutational status. IDH-wild type (Wt) exhibited a slight enhancement (p = 0.039). The ADCm values in IDH-mutant (Mut) patients were higher than those of IDH-Wt patients (p < 0.0004). The value of ADC ≥ 0.99 × 10−3 mm2/s emerged as a “cut-off” to differentiate the mutation state. In the overall group, a positive relationship between the ADCm values and OS was detected (p = 0.003; r = 0.62). Adding quantitative measures of ADC values to conventional MR imaging could be used routinely as a noninvasive marker of specific molecular patterns.

scholarly journals Assessment of Isocitrate Dehydrogenase 1 Genotype and Cell Proliferation in Gliomas Using Multiple Diffusion Magnetic Resonance Imaging

2021 ◽  
Vol 15 ◽  
Author(s):  
Yan Xie ◽  
Shihui Li ◽  
Nanxi Shen ◽  
Tongjia Gan ◽  
Shun Zhang ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cell Proliferation ◽  
Diffusion Coefficient ◽  
Magnetic Resonance ◽  
Isocitrate Dehydrogenase ◽  
Diffusion Magnetic Resonance Imaging ◽  
Wild Type ◽  
Resonance Imaging ◽  
Isocitrate Dehydrogenase 1 ◽  
Ki 67

Objectives: To compare the efficacy of parameters from multiple diffusion magnetic resonance imaging (dMRI) for prediction of isocitrate dehydrogenase 1 (IDH1) genotype and assessment of cell proliferation in gliomas.Methods: Ninety-one patients with glioma underwent diffusion weighted imaging (DWI), multi-b-value DWI, and diffusion kurtosis imaging (DKI)/neurite orientation dispersion and density imaging (NODDI) on 3.0T MRI. Each parameter was compared between IDH1-mutant and IDH1 wild-type groups by Mann–Whitney U test in lower-grade gliomas (LrGGs) and glioblastomas (GBMs), respectively. Further, performance of each parameter was compared for glioma grading under the same IDH1 genotype. Spearman correlation coefficient between Ki-67 labeling index (LI) and each parameter was calculated.Results: The diagnostic performance was better achieved with apparent diffusion coefficient (ADC), slow ADC (D), fast ADC (D∗), perfusion fraction (f), distributed diffusion coefficient (DDC), heterogeneity index (α), mean diffusivity (MD), mean kurtosis (MK), and intracellular volume fraction (ICVF) for distinguishing IDH1 genotypes in LrGGs, with statistically insignificant AUC values from 0.750 to 0.817. In GBMs, no difference between the two groups was found. For IDH1-mutant group, all parameters, except for fractional anisotropy (FA) and D∗, significantly discriminated LrGGs from GBMs (P &lt; 0.05). However, for IDH1 wild-type group, only ADC statistically discriminated the two (P = 0.048). In addition, MK has maximal correlation coefficient (r = 0.567, P &lt; 0.001) with Ki-67 LI.Conclusion: dMRI-derived parameters are promising biomarkers for predicting IDH1 genotype in LrGGs, and MK has shown great potential in assessing glioma cell proliferation.

scholarly journals Mid-treatment magnetic resonance imaging in pediatric intracranial low-grade gliomas treated with proton beam therapy

2017 ◽  
Vol 56 (9) ◽  
pp. 1243-1247
Author(s):  
Radhika Sreeraman Kumar ◽  
Ronny L. Rotondo ◽  
Julie A. Bradley ◽  
Tamara Vern-Gross ◽  
Soon Huh ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Proton Beam ◽  
Proton Beam Therapy ◽  
Low Grade ◽  
Resonance Imaging ◽  
Low Grade Gliomas

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

2015 ◽  
Vol 15 (1) ◽  
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

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

2016 ◽  
Vol 125 (5) ◽  
pp. 1155-1166 ◽  
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.

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

Neurosurgery ◽  
2006 ◽  
Vol 58 (6) ◽  
pp. E1210-E1210 ◽  
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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