Abstract
PurposeCurrently, isocitrate dehydrogenase (IDH) mutation and 1p/19q co-deletion are proven diagnostic biomarkers for both grade II and III oligodendrogliomas (ODs). Non-invasive diffusion-weighted imaging (DWI), susceptibility-weighted imaging (SWI), and dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) are widely used to provide physiological information (cellularity, hemorrhage, calcifications, and angiogenesis) of neoplastic histology and tumor grade. However, it is unclear whether DWI, SWI, and DSC-PWI are able to stratify grades of IDH-mutant and 1p/19q co-deleted ODs.MethodsWe retrospectively reviewed the conventional MRI (cMRI), DWI, SWI, and DSC-PWI obtained on 33 patients with IDH-mutated and 1p/19q co-deleted ODs. Features of cMRI, normalized ADC (nADC), intratumoral susceptibility signals (ITSSs), normalized maxim CBV (nCBV), and normalized maximum CBF (nCBF) were compared between low-grade ODs (LGOs) and high-grade ODs (HGOs). Receiver operating characteristic curve and logistic regression were applied to determine diagnostic performances.ResultsHGOs tended to present with prominent edema and enhancement. nADC, ITSSs, nCBV, and nCBF were significantly different between groups (all P < 0.05). The combination of SWI and DSC-PWI for grading resulted in sensitivity and specificity of 100.00 and 93.33%, respectively.ConclusionsIDH-mutant and 1p/19q co-deleted ODs can be stratified by grades using cMRI and advanced magnetic resonance imaging techniques including DWI, SWI, and DSC-PWI. Combined ITSSs with nCBV appear to be a promising option for grading molecularly defined ODs in clinical practice.
Highlights
Oligodendrogliomas (ODs) are glial neoplasms originated from oligodendrocytes that primarily affect supratentorial parenchyma [1]
Isocitrate dehydrogenase (IDH)-mutant and 1p/19q co-deleted ODs can be stratified by grades using conventional MRI (cMRI) and advanced magnetic resonance imaging techniques including diffusion-weighted imaging (DWI), susceptibility-weighted imaging (SWI), and DSCPWI
The inclusion criteria were (1) a histopathology diagnosis of ODs or oligoastrocytomas according to 2007 World Health Organization (WHO) classification; (2) 3.0 Tesla cMRI scans combined with DWI, SWI, and DSCPWI before any intervention; and (3) a known IDH mutation and 1p/19q co-deletion status for reclassification according to 2016 WHO guidelines
Summary
Oligodendrogliomas (ODs) are glial neoplasms originated from oligodendrocytes that primarily affect supratentorial parenchyma [1]. These entities were previously classified into grades II and III according to the 2007 World Health Organization (WHO) classification system of the central nervous system (CNS). Progression-free survival (PFS) and overall survival (OS) of ODs between grades are dramatically different after adjustment for genotypes (defined by 1p/19q co-deletion) [7]. Isocitrate dehydrogenase (IDH) mutation is frequently found in WHO grade II–III oligodendrogliomas and astrocytomas [8, 9], and is currently implicated as a prerequisite of tumorigenesis for some types of diffuse gliomas and a precondition of 1p/19q co-deletion [10, 11]. According to the 2016 WHO classification system, the Bintegrated diagnosis^ of ODs requires histological classification, WHO grade, and molecular
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