Department of Clinical Neurological Sciences (Neurosurgery), Western University, London, ON, Canada.
Imaging Research Laboratories, Robarts Research Institute, London, ON, Canada.
J Neurooncol. 2018 Aug;139(1):167-175. doi: 10.1007/s11060-018-2857-x. Epub 2018 Apr 9.
Diffuse low-grade gliomas (LGGs) are infiltrative, slow-growing primary brain tumors that remain relatively asymptomatic for long periods of time before progressing into aggressive and fatal high-grade gliomas.
We retrospectively identified LGG patients with numerous (≥ 8) serial magnetic resonance imaging (MRI) studies. Tumor volumes were measured by manual segmentation on serial imaging to study the natural history and growth of the lesion. Patient demographic information, tumor characteristics, and histological data were collected from electronic medical records and paper charts.
Out of 74 LGG patients, 10 patients (13.5%) were identified to meet the study criteria with number of MRIs acquired ranging from 8 to 18 (median, 11.5) over a median of 79.7 months (range 39.8-113.8 months). Tumor diameter increased at a median of 2.17 mm/year in a linear trajectory. Cox regression analysis revealed that initial tumor volume was an independent predictor of time to clinical intervention, and Mann-Whitney U test found that patients younger than 50 years old had significantly slower-growing tumors. Clinical intervention was more likely for tumors above a volume threshold of 73.6 mL.
We retrospectively analyzed the natural history of LGGs of patients managed at a single institution with numerous serial MRI scans. Comparisons of our cohort to the literature suggest that this is a subset of particularly slow-growing and low-risk tumors.
弥漫性低级别胶质瘤（LGG）是浸润性的、生长缓慢的原发性脑肿瘤，在进展为侵袭性和致命性高级别胶质瘤之前，很长一段时间内相对无症状。
我们回顾性地确定了有大量（≥8 次）连续磁共振成像（MRI）研究的 LGG 患者。通过对连续成像进行手动分割来测量肿瘤体积，以研究病变的自然史和生长情况。从电子病历和纸质图表中收集患者的人口统计学信息、肿瘤特征和组织学数据。
在 74 名 LGG 患者中，有 10 名患者（13.5%）符合研究标准，获得的 MRI 数量从 8 次到 18 次（中位数为 11.5 次），中位数为 79.7 个月（范围 39.8-113.8 个月）。肿瘤直径以线性轨迹平均每年增加 2.17 毫米。Cox 回归分析显示，初始肿瘤体积是临床干预时间的独立预测因子，曼-惠特尼 U 检验发现，年龄小于 50 岁的患者肿瘤生长速度明显较慢。临床干预更有可能发生在体积超过 73.6 毫升的肿瘤上。
我们回顾性分析了在单一机构接受大量连续 MRI 扫描治疗的 LGG 患者的自然史。与文献相比，我们的队列表明这是一组特别生长缓慢和低风险的肿瘤。
