Abstract
BackgroundLow‐grade gliomas (LGGs) are primary diffuse slow‐growing brain tumors derived from glial cells. The management of these tumors is dependent on their location, which often harbors eloquent areas. We retrospectively recorded the location of diffuse gliomas to identify whether specific differences exist between the histological types.MethodsWe analyzed 102 patients with previous histological diagnosis of WHO‐II astrocytomas (62) and WHO‐II oligodendrogliomas (40) according to WHO‐2016 classification. MRI sequences (T2‐FLAIR) were used for tumor volume segmentation and to create a frequency map of their locations within the Montreal Neurological Institute (MNI) space. The Brain‐Grid (BG) system (standardized radiological tool of intersected lines according to anatomical landmarks) was created and merged with a tractography atlas for infiltration analysis.ResultsAstrocytomas frequently infiltrated association and projection white matter pathways within fronto‐temporo‐insular regions on the left side. Oligodendrogliomas infiltrated larger white matter networks (association‐commissural‐projection) of the frontal lobe bilaterally. A critical number of infiltrated BG voxels (7 for astrocytomas, 10 for oligodendrogliomas) significantly predicted shorter overall survival (OS) in both groups. Bilateral tumor extension in astrocytomas and preoperative tumor volume in oligodendrogliomas were independent prognostic factors for shorter OS.ConclusionsAstrocytomas and oligodendrogliomas differ in preferential location, and this has an impact on the type and the extent of white matter involvement. The number of BG voxels infiltrated reflected different tumor invasiveness and its impact on OS in both groups. All this new information may be valuable in neurosurgical oncology to classify and plan treatment for patients with diffuse gliomas.
Highlights
Central nervous system (CNS) tumors are defined by their cell of origin and their histopathological characteristics, which predict their behavior.[1]
A second block was used for interaction analysis between the more relevant categorical variables and numerical variables
In the oligodendrogliomas' group, no difference was displayed between LOH1p19q+ and NOS for age (P = .190), survival from diagnosis (P = .878), number of BG voxels (P = .474), volume (P = .492), extent of resection (EOR) (P = .156), radiological borders (P = .399), and eloquent white matter infiltration (P = .866)
Summary
Central nervous system (CNS) tumors are defined by their cell of origin and their histopathological characteristics, which predict their behavior.[1] Low-grade gliomas (LGGs) are WHO grade II tumors that affect mostly adult patients and include diffuse astrocytomas and diffuse oligodendrogliomas.[2,3] The clinical course of low-grade gliomas is diverse with a peak incidence around 30-40 years and the tendency to recur or to transform into high-grade gliomas.[4] The management of these tumors is dependent on their location. | 5447 functional networks were preferentially invaded by the tumor subgroups
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