Magnetic resonance spectroscopic correlates of progression free and overall survival in "glioblastoma, IDH-wildtype, WHO grade-4".

Autor: Sacli-Bilmez B; Institute of Biomedical Engineering, Bogazici University, Istanbul, Türkiye., Danyeli AE; Department of Pathology, School of Medicine, Acıbadem Mehmet Ali Aydinlar University, Istanbul, Türkiye.; Center for Neuroradiological Applications and Research, Acıbadem Mehmet Ali Aydinlar University, Istanbul, Türkiye., Yakicier MC; YoctoSensum Biotechnology, Istanbul, Türkiye., Aras FK; Department of Neuropathology, University of Heidelberg, Heidelberg, Germany., Pamir MN; Center for Neuroradiological Applications and Research, Acıbadem Mehmet Ali Aydinlar University, Istanbul, Türkiye.; Department of Neurosurgery, School of Medicine, Acıbadem Mehmet Ali Aydinlar University, Istanbul, Türkiye., Özduman K; Center for Neuroradiological Applications and Research, Acıbadem Mehmet Ali Aydinlar University, Istanbul, Türkiye.; Department of Neurosurgery, School of Medicine, Acıbadem Mehmet Ali Aydinlar University, Istanbul, Türkiye., Dinçer A; Center for Neuroradiological Applications and Research, Acıbadem Mehmet Ali Aydinlar University, Istanbul, Türkiye.; Department of Radiology, School of Medicine, Acıbadem Mehmet Ali Aydinlar University, Istanbul, Türkiye., Ozturk-Isik E; Institute of Biomedical Engineering, Bogazici University, Istanbul, Türkiye.; Center for Neuroradiological Applications and Research, Acıbadem Mehmet Ali Aydinlar University, Istanbul, Türkiye.
Jazyk: angličtina
Zdroj: Frontiers in neuroscience [Front Neurosci] 2023 Jun 29; Vol. 17, pp. 1149292. Date of Electronic Publication: 2023 Jun 29 (Print Publication: 2023).
DOI: 10.3389/fnins.2023.1149292
Abstrakt: Background: The 2021 World Health Organization (WHO) Central Nervous System (CNS) Tumor Classification has suggested that isocitrate dehydrogenase wildtype (IDH-wt) WHO grade-2/3 astrocytomas with molecular features of glioblastoma should be designated as "Glioblastoma, IDH-wildtype, WHO grade-4." This study analyzed the metabolic correlates of progression free and overall survival in "Glioblastoma, IDH-wildtype, WHO grade-4" patients using short echo time single voxel 1 H-MRS.
Methods: Fifty-seven adult patients with hemispheric glioma fulfilling the 2021 WHO CNS Tumor Classification criteria for "Glioblastoma, IDH-wildtype, WHO grade-4" at presurgery time point were included. All patients were IDH1/2 -wt and TERT p-mut. 1 H-MRS was performed on a 3 T MR scanner and post-processed using LCModel. A Mann-Whitney U test was used to assess the metabolic differences between gliomas with or without contrast enhancement and necrosis. Cox regression analysis was used to assess the effects of age, extent of resection, presence of contrast enhancement and necrosis, and metabolic intensities on progression-free survival (PFS) and overall survival (OS). Machine learning algorithms were employed to discern possible metabolic patterns attributable to higher PFS or OS.
Results: Contrast enhancement ( p  = 0.015), necrosis ( p  = 0.012); and higher levels of Glu/tCr ( p  = 0.007), GSH/tCr ( p  = 0.019), tCho/tCr ( p  = 0.032), and Glx/tCr ( p  = 0.010) were significantly associated with shorter PFS. Additionally, necrosis ( p  = 0.049), higher Glu/tCr ( p  = 0.039), and Glx/tCr ( p  = 0.047) were significantly associated with worse OS. Machine learning models differentiated the patients having longer than 12 months OS with 81.71% accuracy and the patients having longer than 6 months PFS with 77.41% accuracy.
Conclusion: Glx and GSH have been identified as important metabolic correlates of patient survival among "IDH-wt, TERT-mut diffuse gliomas" using single-voxel 1 H-MRS on a clinical 3 T MRI scanner.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2023 Sacli-Bilmez, Danyeli, Yakicier, Aras, Pamir, Özduman, Dinçer and Ozturk-Isik.)
Databáze: MEDLINE
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