Prognostic Value of Preoperative MRI Metrics for Diffuse Lower-Grade Glioma Molecular Subtypes
Despite the improved prognostic relevance of the 2016 WHO molecular-based classification of lower-grade gliomas, variability in clinical outcome persists within existing molecular subtypes. Our aim was to determine prognostically significant metrics on preoperative MR imaging for lower-grade gliomas...
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| Veröffentlicht in: | American journal of neuroradiology : AJNR 2020-05, Vol.41 (5), p.815-821 |
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| creator | Darvishi, P Batchala, P P Patrie, J T Poisson, L M Lopes, M-B Jain, R Fadul, C E Schiff, D Patel, S H |
| description | Despite the improved prognostic relevance of the 2016 WHO molecular-based classification of lower-grade gliomas, variability in clinical outcome persists within existing molecular subtypes. Our aim was to determine prognostically significant metrics on preoperative MR imaging for lower-grade gliomas within currently defined molecular categories.
We undertook a retrospective analysis of 306 patients with lower-grade gliomas accrued from an institutional data base and The Cancer Genome Atlas. Two neuroradiologists in consensus analyzed preoperative MRIs of each lower-grade glioma to determine the following: tumor size, tumor location, number of involved lobes, corpus callosum involvement, hydrocephalus, midline shift, eloquent cortex involvement, ependymal extension, margins, contrast enhancement, and necrosis. Adjusted hazard ratios determined the association between MR imaging metrics and overall survival per molecular subtype, after adjustment for patient age, patient sex, World Health Organization grade, and surgical resection status.
For
(
) wild-type lower-grade gliomas, tumor size (hazard ratio, 3.82; 95% CI, 1.94-7.75; |
| doi_str_mv | 10.3174/ajnr.A6511 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7228183</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2394884326</sourcerecordid><originalsourceid>FETCH-LOGICAL-c378t-ac0e387d7c07dc1542a66ebb6453bce6a32d9d612153c1adcdf57b4f6d966fe53</originalsourceid><addsrcrecordid>eNpVkclKLDEUQIM80XbYvA-QLB9CaYZKUrURxKEVulGccPVCKrnRSHWlTaoU_952RFd3cQ_nXjgI_aVkh1NV7pqHLu3sS0HpEhrRmsuiFvXtHzQitBaFpKRaRWs5PxBCRK3YClrljDNV8nKE_p-neNfF3AeLb0w7AI4enyeIc0imD0-ApxeneAp9CjZjHxM-DN4PGfAkPkMqxsk4wOM2xJnB09iCHVqT8OXQ9C9zyBto2Zs2w-bnXEfXx0dXByfF5Gx8erA_KSxXVV8YS4BXyilLlLNUlMxICU0jS8EbC9Jw5monKaOCW2qcdV6opvTS1VJ6EHwd7X1450MzA2eh65Np9TyFmUkvOpqgf2-6cK_v4pNWjFW04gvBv09Bio8D5F7PQrbQtqaDOGTNeF1WVcmZXKDbH6hNMecE_vsMJfotiH4Lot-DLOCtn499o18F-CveOYlW</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2394884326</pqid></control><display><type>article</type><title>Prognostic Value of Preoperative MRI Metrics for Diffuse Lower-Grade Glioma Molecular Subtypes</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>Darvishi, P ; Batchala, P P ; Patrie, J T ; Poisson, L M ; Lopes, M-B ; Jain, R ; Fadul, C E ; Schiff, D ; Patel, S H</creator><creatorcontrib>Darvishi, P ; Batchala, P P ; Patrie, J T ; Poisson, L M ; Lopes, M-B ; Jain, R ; Fadul, C E ; Schiff, D ; Patel, S H</creatorcontrib><description>Despite the improved prognostic relevance of the 2016 WHO molecular-based classification of lower-grade gliomas, variability in clinical outcome persists within existing molecular subtypes. Our aim was to determine prognostically significant metrics on preoperative MR imaging for lower-grade gliomas within currently defined molecular categories.
We undertook a retrospective analysis of 306 patients with lower-grade gliomas accrued from an institutional data base and The Cancer Genome Atlas. Two neuroradiologists in consensus analyzed preoperative MRIs of each lower-grade glioma to determine the following: tumor size, tumor location, number of involved lobes, corpus callosum involvement, hydrocephalus, midline shift, eloquent cortex involvement, ependymal extension, margins, contrast enhancement, and necrosis. Adjusted hazard ratios determined the association between MR imaging metrics and overall survival per molecular subtype, after adjustment for patient age, patient sex, World Health Organization grade, and surgical resection status.
For
(
) wild-type lower-grade gliomas, tumor size (hazard ratio, 3.82; 95% CI, 1.94-7.75;
< .001), number of involved lobes (hazard ratio, 1.70; 95% CI, 1.28-2.27;
< .001), hydrocephalus (hazard ratio, 4.43; 95% CI, 1.12-17.54;
= .034), midline shift (hazard ratio, 1.16; 95% CI, 1.03-1.30;
= .013), margins (
= .031), and contrast enhancement (hazard ratio, 0.34; 95% CI, 0.13-0.90;
= .030) were associated with overall survival. For
-mutant 1p/19q-codeleted lower-grade gliomas, tumor size (hazard ratio, 2.85; 95% CI, 1.06-7.70;
= .039) and ependymal extension (hazard ratio, 6.34; 95% CI, 1.07-37.59;
= .042) were associated with overall survival.
MR imaging metrics offers prognostic information for patients with lower-grade gliomas within molecularly defined classes, with the greatest prognostic value for
wild-type lower-grade gliomas.</description><identifier>ISSN: 0195-6108</identifier><identifier>EISSN: 1936-959X</identifier><identifier>DOI: 10.3174/ajnr.A6511</identifier><identifier>PMID: 32327434</identifier><language>eng</language><publisher>United States: American Society of Neuroradiology</publisher><subject>Adolescent ; Adult ; Adult Brain ; Aged ; Brain Neoplasms - diagnostic imaging ; Brain Neoplasms - mortality ; Brain Neoplasms - pathology ; Female ; Glioma - diagnostic imaging ; Glioma - mortality ; Glioma - pathology ; Humans ; Isocitrate Dehydrogenase - genetics ; Magnetic Resonance Imaging - methods ; Male ; Middle Aged ; Mutation ; Prognosis ; Retrospective Studies ; Young Adult</subject><ispartof>American journal of neuroradiology : AJNR, 2020-05, Vol.41 (5), p.815-821</ispartof><rights>2020 by American Journal of Neuroradiology.</rights><rights>2020 by American Journal of Neuroradiology 2020 American Journal of Neuroradiology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c378t-ac0e387d7c07dc1542a66ebb6453bce6a32d9d612153c1adcdf57b4f6d966fe53</citedby><cites>FETCH-LOGICAL-c378t-ac0e387d7c07dc1542a66ebb6453bce6a32d9d612153c1adcdf57b4f6d966fe53</cites><orcidid>0000-0003-3895-9738 ; 0000-0002-1896-2502 ; 0000-0002-4879-0457 ; 0000-0001-7392-830X ; 0000-0002-3409-6536 ; 0000-0002-9739-4362 ; 0000-0001-8661-6727 ; 0000-0002-3744-7012 ; 0000-0001-7459-7661</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7228183/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7228183/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32327434$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Darvishi, P</creatorcontrib><creatorcontrib>Batchala, P P</creatorcontrib><creatorcontrib>Patrie, J T</creatorcontrib><creatorcontrib>Poisson, L M</creatorcontrib><creatorcontrib>Lopes, M-B</creatorcontrib><creatorcontrib>Jain, R</creatorcontrib><creatorcontrib>Fadul, C E</creatorcontrib><creatorcontrib>Schiff, D</creatorcontrib><creatorcontrib>Patel, S H</creatorcontrib><title>Prognostic Value of Preoperative MRI Metrics for Diffuse Lower-Grade Glioma Molecular Subtypes</title><title>American journal of neuroradiology : AJNR</title><addtitle>AJNR Am J Neuroradiol</addtitle><description>Despite the improved prognostic relevance of the 2016 WHO molecular-based classification of lower-grade gliomas, variability in clinical outcome persists within existing molecular subtypes. Our aim was to determine prognostically significant metrics on preoperative MR imaging for lower-grade gliomas within currently defined molecular categories.
We undertook a retrospective analysis of 306 patients with lower-grade gliomas accrued from an institutional data base and The Cancer Genome Atlas. Two neuroradiologists in consensus analyzed preoperative MRIs of each lower-grade glioma to determine the following: tumor size, tumor location, number of involved lobes, corpus callosum involvement, hydrocephalus, midline shift, eloquent cortex involvement, ependymal extension, margins, contrast enhancement, and necrosis. Adjusted hazard ratios determined the association between MR imaging metrics and overall survival per molecular subtype, after adjustment for patient age, patient sex, World Health Organization grade, and surgical resection status.
For
(
) wild-type lower-grade gliomas, tumor size (hazard ratio, 3.82; 95% CI, 1.94-7.75;
< .001), number of involved lobes (hazard ratio, 1.70; 95% CI, 1.28-2.27;
< .001), hydrocephalus (hazard ratio, 4.43; 95% CI, 1.12-17.54;
= .034), midline shift (hazard ratio, 1.16; 95% CI, 1.03-1.30;
= .013), margins (
= .031), and contrast enhancement (hazard ratio, 0.34; 95% CI, 0.13-0.90;
= .030) were associated with overall survival. For
-mutant 1p/19q-codeleted lower-grade gliomas, tumor size (hazard ratio, 2.85; 95% CI, 1.06-7.70;
= .039) and ependymal extension (hazard ratio, 6.34; 95% CI, 1.07-37.59;
= .042) were associated with overall survival.
MR imaging metrics offers prognostic information for patients with lower-grade gliomas within molecularly defined classes, with the greatest prognostic value for
wild-type lower-grade gliomas.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adult Brain</subject><subject>Aged</subject><subject>Brain Neoplasms - diagnostic imaging</subject><subject>Brain Neoplasms - mortality</subject><subject>Brain Neoplasms - pathology</subject><subject>Female</subject><subject>Glioma - diagnostic imaging</subject><subject>Glioma - mortality</subject><subject>Glioma - pathology</subject><subject>Humans</subject><subject>Isocitrate Dehydrogenase - genetics</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mutation</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Young Adult</subject><issn>0195-6108</issn><issn>1936-959X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkclKLDEUQIM80XbYvA-QLB9CaYZKUrURxKEVulGccPVCKrnRSHWlTaoU_952RFd3cQ_nXjgI_aVkh1NV7pqHLu3sS0HpEhrRmsuiFvXtHzQitBaFpKRaRWs5PxBCRK3YClrljDNV8nKE_p-neNfF3AeLb0w7AI4enyeIc0imD0-ApxeneAp9CjZjHxM-DN4PGfAkPkMqxsk4wOM2xJnB09iCHVqT8OXQ9C9zyBto2Zs2w-bnXEfXx0dXByfF5Gx8erA_KSxXVV8YS4BXyilLlLNUlMxICU0jS8EbC9Jw5monKaOCW2qcdV6opvTS1VJ6EHwd7X1450MzA2eh65Np9TyFmUkvOpqgf2-6cK_v4pNWjFW04gvBv09Bio8D5F7PQrbQtqaDOGTNeF1WVcmZXKDbH6hNMecE_vsMJfotiH4Lot-DLOCtn499o18F-CveOYlW</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Darvishi, P</creator><creator>Batchala, P P</creator><creator>Patrie, J T</creator><creator>Poisson, L M</creator><creator>Lopes, M-B</creator><creator>Jain, R</creator><creator>Fadul, C E</creator><creator>Schiff, D</creator><creator>Patel, S H</creator><general>American Society of Neuroradiology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3895-9738</orcidid><orcidid>https://orcid.org/0000-0002-1896-2502</orcidid><orcidid>https://orcid.org/0000-0002-4879-0457</orcidid><orcidid>https://orcid.org/0000-0001-7392-830X</orcidid><orcidid>https://orcid.org/0000-0002-3409-6536</orcidid><orcidid>https://orcid.org/0000-0002-9739-4362</orcidid><orcidid>https://orcid.org/0000-0001-8661-6727</orcidid><orcidid>https://orcid.org/0000-0002-3744-7012</orcidid><orcidid>https://orcid.org/0000-0001-7459-7661</orcidid></search><sort><creationdate>202005</creationdate><title>Prognostic Value of Preoperative MRI Metrics for Diffuse Lower-Grade Glioma Molecular Subtypes</title><author>Darvishi, P ; Batchala, P P ; Patrie, J T ; Poisson, L M ; Lopes, M-B ; Jain, R ; Fadul, C E ; Schiff, D ; Patel, S H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c378t-ac0e387d7c07dc1542a66ebb6453bce6a32d9d612153c1adcdf57b4f6d966fe53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Adult Brain</topic><topic>Aged</topic><topic>Brain Neoplasms - diagnostic imaging</topic><topic>Brain Neoplasms - mortality</topic><topic>Brain Neoplasms - pathology</topic><topic>Female</topic><topic>Glioma - diagnostic imaging</topic><topic>Glioma - mortality</topic><topic>Glioma - pathology</topic><topic>Humans</topic><topic>Isocitrate Dehydrogenase - genetics</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mutation</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Darvishi, P</creatorcontrib><creatorcontrib>Batchala, P P</creatorcontrib><creatorcontrib>Patrie, J T</creatorcontrib><creatorcontrib>Poisson, L M</creatorcontrib><creatorcontrib>Lopes, M-B</creatorcontrib><creatorcontrib>Jain, R</creatorcontrib><creatorcontrib>Fadul, C E</creatorcontrib><creatorcontrib>Schiff, D</creatorcontrib><creatorcontrib>Patel, S H</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of neuroradiology : AJNR</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Darvishi, P</au><au>Batchala, P P</au><au>Patrie, J T</au><au>Poisson, L M</au><au>Lopes, M-B</au><au>Jain, R</au><au>Fadul, C E</au><au>Schiff, D</au><au>Patel, S H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Value of Preoperative MRI Metrics for Diffuse Lower-Grade Glioma Molecular Subtypes</atitle><jtitle>American journal of neuroradiology : AJNR</jtitle><addtitle>AJNR Am J Neuroradiol</addtitle><date>2020-05</date><risdate>2020</risdate><volume>41</volume><issue>5</issue><spage>815</spage><epage>821</epage><pages>815-821</pages><issn>0195-6108</issn><eissn>1936-959X</eissn><abstract>Despite the improved prognostic relevance of the 2016 WHO molecular-based classification of lower-grade gliomas, variability in clinical outcome persists within existing molecular subtypes. Our aim was to determine prognostically significant metrics on preoperative MR imaging for lower-grade gliomas within currently defined molecular categories.
We undertook a retrospective analysis of 306 patients with lower-grade gliomas accrued from an institutional data base and The Cancer Genome Atlas. Two neuroradiologists in consensus analyzed preoperative MRIs of each lower-grade glioma to determine the following: tumor size, tumor location, number of involved lobes, corpus callosum involvement, hydrocephalus, midline shift, eloquent cortex involvement, ependymal extension, margins, contrast enhancement, and necrosis. Adjusted hazard ratios determined the association between MR imaging metrics and overall survival per molecular subtype, after adjustment for patient age, patient sex, World Health Organization grade, and surgical resection status.
For
(
) wild-type lower-grade gliomas, tumor size (hazard ratio, 3.82; 95% CI, 1.94-7.75;
< .001), number of involved lobes (hazard ratio, 1.70; 95% CI, 1.28-2.27;
< .001), hydrocephalus (hazard ratio, 4.43; 95% CI, 1.12-17.54;
= .034), midline shift (hazard ratio, 1.16; 95% CI, 1.03-1.30;
= .013), margins (
= .031), and contrast enhancement (hazard ratio, 0.34; 95% CI, 0.13-0.90;
= .030) were associated with overall survival. For
-mutant 1p/19q-codeleted lower-grade gliomas, tumor size (hazard ratio, 2.85; 95% CI, 1.06-7.70;
= .039) and ependymal extension (hazard ratio, 6.34; 95% CI, 1.07-37.59;
= .042) were associated with overall survival.
MR imaging metrics offers prognostic information for patients with lower-grade gliomas within molecularly defined classes, with the greatest prognostic value for
wild-type lower-grade gliomas.</abstract><cop>United States</cop><pub>American Society of Neuroradiology</pub><pmid>32327434</pmid><doi>10.3174/ajnr.A6511</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-3895-9738</orcidid><orcidid>https://orcid.org/0000-0002-1896-2502</orcidid><orcidid>https://orcid.org/0000-0002-4879-0457</orcidid><orcidid>https://orcid.org/0000-0001-7392-830X</orcidid><orcidid>https://orcid.org/0000-0002-3409-6536</orcidid><orcidid>https://orcid.org/0000-0002-9739-4362</orcidid><orcidid>https://orcid.org/0000-0001-8661-6727</orcidid><orcidid>https://orcid.org/0000-0002-3744-7012</orcidid><orcidid>https://orcid.org/0000-0001-7459-7661</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Adult Brain Aged Brain Neoplasms - diagnostic imaging Brain Neoplasms - mortality Brain Neoplasms - pathology Female Glioma - diagnostic imaging Glioma - mortality Glioma - pathology Humans Isocitrate Dehydrogenase - genetics Magnetic Resonance Imaging - methods Male Middle Aged Mutation Prognosis Retrospective Studies Young Adult |
| title | Prognostic Value of Preoperative MRI Metrics for Diffuse Lower-Grade Glioma Molecular Subtypes |
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