Keywords:
Neuro, CNS, Neuroradiology brain, MR, MR-Diffusion/Perfusion, MR-Spectroscopy, Biopsy, Radiobiology, Staging, Cancer, Gene therapy, Molecular, genomics and proteomics, Prospective, Observational, Performed at one institution
Authors:
A. J. BARRIOS LOPEZ, A. Palpán Flores, C. Viváncos Sánchez, E. Lanz Santos, F. García Martínez, J. M. Roda Frade, G. Garzón Moll, A. ROYO OREJAS, C. Utrilla Contreras; Madrid/ES
DOI:
10.26044/ecr2020/C-07601
Results
The mean age of our sample was 53.9 ± 13.5, 58.5% of men and 41.5% of women. Regarding tumour location, 60.5% were located on the right hemispheric of the brain and 39.5% on the left. The most affected región was the frontal lobe (36%) followed by the temporal lobe (28%), the parietal lobe (21%) and the occipital lobe (15%), whereas 7.6% of patients had multicentric tumours. The grade and genetics of the diffuse glioma are illustrated in Fig. 1. Most of the tumours were WHO grade IV gliomas (79.3%), IDH wild-type with unmethylated-MGMT (66.7%).
Fig. 1: Proportion of the grades and genetics of diffuse gliomas.
The presence of necrosis, an apparent diffusion coefficient (ADC) < 900 x 10⁻⁶ mm2/s and a relative cerebral blood volume (rCBV) > 1.5 have the strongest association with wild-type diffuse gliomas. In addition, a qualitative analysis of MRS that suggests aggressivity (high Choline/NAA ratio, lactate peak) was observed in wild-type diffuse gliomas ( Fig. 2 and Fig. 3 ).
Fig. 2: Evaluation of the accuracy of MRI findings for predicting IDH status.
Fig. 3: Case example.
In the group of wild-type GB, age and MGMT methylation status were capable of predicting survival ( Fig. 4 and Fig. 5 ).
Fig. 4: Survival analysis.
Fig. 5: Effect of an idenpendent predictor variable upon survival (Cox regression)