Korean J Radiol.  2021 Feb;22(2):233-242. 10.3348/kjr.2020.0011.

Comparison of Genetic Profiles and Prognosis of High-Grade Gliomas Using Quantitative and Qualitative MRI Features: A Focus on G3 Gliomas

Affiliations
  • 1Department of Radiology, Seoul National University Hospital, Seoul, Korea.
  • 2Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
  • 3Department of Pathology, Seoul National University Hospital, Seoul, Korea.
  • 4Department of Internal Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • 5Department of Neurosurgery, Biomedical Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • 6Department of Radiation Oncology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • 7Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.

Abstract


Objective
To evaluate the association of MRI features with the major genomic profiles and prognosis of World Health Organization grade III (G3) gliomas compared with those of glioblastomas (GBMs).
Materials and Methods
We enrolled 76 G3 glioma and 155 GBM patients with pathologically confirmed disease who had pretreatment brain MRI and major genetic information of tumors. Qualitative and quantitative imaging features, including volumetrics and histogram parameters, such as normalized cerebral blood volume (nCBV), cerebral blood flow (nCBF), and apparent diffusion coefficient (nADC) were evaluated. The G3 gliomas were divided into three groups for the analysis: with this isocitrate dehydrogenase (IDH)-mutation, IDH mutation and a chromosome arm 1p/19q-codeleted (IDHmut1p/19qdel), IDH mutation, 1p/19q-nondeleted (IDHmut1p/19qnondel), and IDH wildtype (IDHwt). A prediction model for the genetic profiles of G3 gliomas was developed and validated on a separate cohort. Both the quantitative and qualitative imaging parameters and progression-free survival (PFS) of G3 gliomas were compared and survival analysis was performed. Moreover, the imaging parameters and PFS between IDHwt G3 gliomas and GBMs were compared.
Results
IDHmut G3 gliomas showed a larger volume (p = 0.017), lower nCBF (p = 0.048), and higher nADC (p = 0.007) than IDHwt. Between the IDHmut tumors, IDHmut1p/19qdel G3 gliomas had higher nCBV (p = 0.024) and lower nADC (p = 0.002) than IDHmut1p/19qnondel G3 gliomas. Moreover, IDHmut1p/19qdel tumors had the best prognosis and IDHwt tumors had the worst prognosis among G3 gliomas (p < 0.001). PFS was significantly associated with the 95th percentile values of nCBV and nCBF in G3 gliomas. There was no significant difference in neither PFS nor imaging features between IDHwt G3 gliomas and IDHwt GBMs.
Conclusion
We found significant differences in MRI features, including volumetrics, CBV, and ADC, in G3 gliomas, according to IDH mutation and 1p/19q codeletion status, which can be utilized for the prediction of genomic profiles and the prognosis of G3 glioma patients. The MRI signatures and prognosis of IDHwt G3 gliomas tend to follow those of IDHwt GBMs.

Keyword

Magnetic resonance imaging; Glioma; Glioblastoma; Isocitrate dehydrogenase; Apparent diffusion coefficient; Cerebral blood volume; Cerebral blood flow
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