From the Department of Radiology (Y.W.P.), Ewha Womans University College of Medicine, Seoul, Korea.
Departments of Radiology and Research Institute of Radiological Science (Y.W.P., K.H., S.-K.L., S.B., Y.S.C., S.S.A.).
AJNR Am J Neuroradiol. 2018 Jan;39(1):37-42. doi: 10.3174/ajnr.A5421. Epub 2017 Nov 9.
BACKGROUND AND PURPOSE: WHO grade II gliomas are divided into three classes: -wildtype, -mutant and no 1p/19q codeletion, and -mutant and 1p/19q-codeleted. Different molecular subtypes have been reported to have prognostic differences and different chemosensitivity. Our aim was to evaluate the predictive value of imaging phenotypes assessed with the Visually AcceSAble Rembrandt Images lexicon for molecular classification of lower grade gliomas. MATERIALS AND METHODS: MR imaging scans of 175 patients with lower grade gliomas with known mutation and 1p/19q-codeletion status were included (78 grade II and 97 grade III) in the discovery set. MR imaging features were reviewed by using Visually AcceSAble Rembrandt Images (VASARI); their associations with molecular markers were assessed. The predictive power of imaging features for -wild type tumors was evaluated using the Least Absolute Shrinkage and Selection Operator. We tested the model in a validation set (40 subjects). RESULTS: Various imaging features were significantly different according to mutation. Nonlobar location, larger proportion of enhancing tumors, multifocal/multicentric distribution, and poor definition of nonenhancing margins were independent predictors of an wild type according to the Least Absolute Shrinkage and Selection Operator. The areas under the curve for the prediction model were 0.859 and 0.778 in the discovery and validation sets, respectively. The -mutant, 1p/19q-codeleted group frequently had mixed/restricted diffusion characteristics and showed more pial invasion compared with the -mutant, no codeletion group. CONCLUSIONS: Preoperative MR imaging phenotypes are different according to the molecular markers of lower grade gliomas, and they may be helpful in predicting the mutation status.
背景与目的:世界卫生组织(WHO)二级胶质瘤分为三类:-野生型、-突变型且无 1p/19q 联合缺失型、-突变型且 1p/19q 联合缺失型。不同的分子亚型被报道具有预后差异和不同的化疗敏感性。我们的目的是评估使用视觉可及的伦勃朗图像词汇表评估的成像表型对低级别胶质瘤分子分类的预测价值。
材料与方法:本研究纳入了 175 例已知 突变和 1p/19q 联合缺失状态的低级别胶质瘤患者的磁共振成像(MRI)扫描(78 例 II 级和 97 例 III 级)作为发现集。使用视觉可及的伦勃朗图像(VASARI)对 MRI 特征进行回顾性分析,并评估其与分子标志物的相关性。使用最小绝对收缩和选择算子(LASSO)评估成像特征对 -野生型肿瘤的预测能力。我们在验证集(40 例)中对该模型进行了测试。
结果:根据 突变,各种成像特征存在显著差异。非叶状位置、更大比例的增强肿瘤、多灶/多中心分布和非增强边缘定义不良是非 -野生型的独立预测因素。在发现集和验证集中,预测模型的曲线下面积分别为 0.859 和 0.778。-突变、1p/19q 联合缺失组与 -突变、无联合缺失组相比,混合/受限扩散特征更为常见,且脑膜侵犯更为多见。
结论:根据低级别胶质瘤的分子标志物,术前 MRI 表型不同,可能有助于预测 突变状态。
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