Do gliosarcomas have distinct imaging features on routine MRI?

Christoph J Maurer,Felix Joachimski,Roland Roelz,Horst Urbach,Bruno Märkl,Ori Staszewski,Irina Mader

doi:10.1177/19714009211012345

Christoph J Maurer, Felix Joachimski + Show 5 more

Open Access

https://doi.org/10.1177/19714009211012345

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Abstract

PurposeThe aim of this study was the development and external validation of a logistic regression model to differentiate gliosarcoma (GSC) and glioblastoma multiforme (GBM) on standard MR imaging.MethodsA univariate and multivariate analysis was carried out of a logistic regression model to discriminate patients histologically diagnosed with primary GSC and an age and sex-matched group of patients with primary GBM on presurgical MRI with external validation.ResultsIn total, 56 patients with GSC and 56 patients with GBM were included. Evidence of haemorrhage suggested the diagnosis of GSC, whereas cystic components and pial as well as ependymal invasion were more commonly observed in GBM patients. The logistic regression model yielded a mean area under the curve (AUC) of 0.919 on the training dataset and of 0.746 on the validation dataset. The accuracy in the validation dataset was 0.67 with a sensitivity of 0.85 and a specificity of 0.5.ConclusionsAlthough some imaging criteria suggest the diagnosis of GSC or GBM, differentiation between these two tumour entities on standard MRI alone is not feasible.

Highlights

Gliosarcoma (GSC) is a rare IDH-wildtype variant of glioblastoma (GBM) accounting for approximately 1.8 to 8% of all glioblastomas.[1,2,3] The entity is defined by the coexistence of glial and mesenchymal components
Seems to be worse in GSC compared to GBM,[8,9,10,11,12,13,14] which raises the question whether GSC should be treated more aggressively
We could not reproduce the association of dural involvement and predilection for the temporal lobe with GSC as a distinguishing feature from GBM suggested by other investigations;[1,17,26] both did not predict GSC in our model

Summary

Introduction

Gliosarcoma (GSC) is a rare IDH-wildtype variant of glioblastoma (GBM) accounting for approximately 1.8 to 8% of all glioblastomas.[1,2,3] The entity is defined by the coexistence of glial and mesenchymal components. Seems to be worse in GSC compared to GBM,[8,9,10,11,12,13,14] which raises the question whether GSC should be treated more aggressively

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Conclusion