Imaging correlates for the 2016 update on WHO classification of grade II/III gliomas: implications for IDH, 1p/19q and ATRX status.

Autor: Delfanti RL; Department of Radiology, University of California, San Diego, 200 West Arbor Drive, La Jolla, CA, 92037, USA. rdelfanti@ucsd.edu.; Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, 92037, USA. rdelfanti@ucsd.edu., Piccioni DE; Department of Neurosciences, University of California, San Diego, La Jolla, CA, 92037, USA., Handwerker J; Department of Radiology, University of California, San Diego, 200 West Arbor Drive, La Jolla, CA, 92037, USA., Bahrami N; Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, 92037, USA., Krishnan A; Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, 92037, USA., Karunamuni R; Department of Radiation Medicine, University of California, San Diego, La Jolla, CA, 92037, USA., Hattangadi-Gluth JA; Department of Radiation Medicine, University of California, San Diego, La Jolla, CA, 92037, USA., Seibert TM; Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, 92037, USA.; Department of Radiation Medicine, University of California, San Diego, La Jolla, CA, 92037, USA., Srikant A; Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, 92037, USA., Jones KA; Department of Pathology, University of Iowa Hospitals & Clinics, Iowa City, IA, 52242, USA., Snyder VS; Department of Pathology, University of California, San Diego, La Jolla, CA, 92093, USA., Dale AM; Department of Radiology, University of California, San Diego, 200 West Arbor Drive, La Jolla, CA, 92037, USA.; Department of Neurosciences, University of California, San Diego, La Jolla, CA, 92037, USA.; Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, 92037, USA., White NS; Department of Radiology, University of California, San Diego, 200 West Arbor Drive, La Jolla, CA, 92037, USA.; Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, 92037, USA., McDonald CR; Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, 92037, USA.; Department of Radiation Medicine, University of California, San Diego, La Jolla, CA, 92037, USA.; Department of Psychiatry, University of California, San Diego, La Jolla, CA, 92037, USA., Farid N; Department of Radiology, University of California, San Diego, 200 West Arbor Drive, La Jolla, CA, 92037, USA.; Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, 92037, USA.
Jazyk: angličtina
Zdroj: Journal of neuro-oncology [J Neurooncol] 2017 Dec; Vol. 135 (3), pp. 601-609. Date of Electronic Publication: 2017 Sep 04.
DOI: 10.1007/s11060-017-2613-7
Abstrakt: The 2016 World Health Organization Classification of Tumors of the Central Nervous System incorporates the use of molecular information into the classification of brain tumors, including grade II and III gliomas, providing new prognostic information that cannot be delineated based on histopathology alone. We hypothesized that these genomic subgroups may also have distinct imaging features. A retrospective single institution study was performed on 40 patients with pathologically proven infiltrating WHO grade II/III gliomas with a pre-treatment MRI and molecular data on IDH, chromosomes 1p/19q and ATRX status. Two blinded Neuroradiologists qualitatively assessed MR features. The relationship between each parameter and molecular subgroup (IDH-wildtype; IDH-mutant-1p/19q codeleted-ATRX intact; IDH-mutant-1p/19q intact-ATRX loss) was evaluated with Fisher's exact test. Progression free survival (PFS) was also analyzed. A border that could not be defined on FLAIR was most characteristic of IDH-wildtype tumors, whereas IDH-mutant tumors demonstrated either well-defined or slightly ill-defined borders (p = 0.019). Degree of contrast enhancement and presence of restricted diffusion did not distinguish molecular subgroups. Frontal lobe predominance was associated with IDH-mutant tumors (p = 0.006). The IDH-wildtype subgroup had significantly shorter PFS than the IDH-mutant groups (p < 0.001). No differences in PFS were present when separating by tumor grade. FLAIR border patterns and tumor location were associated with distinct molecular subgroups of grade II/III gliomas. These imaging features may provide fundamental prognostic and predictive information at time of initial diagnostic imaging.
Databáze: MEDLINE
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