European Association for Neuro-Oncology (EANO) guideline on the diagnosis and treatment of adult astrocytic and oligodendroglial gliomas

Weller, Michael; Bent, Martin J. van den; Tonn, Jörg C.; Stupp, Roger; Preusser, Matthias; Cohen-Jonathan-Moyal, Elizabeth; Henriksson, Roger; Rhun, Émilie Le; Balañá, Carmen; Chinot, Olivier; Bendszus, Martin; Reijneveld, Jaap C.; Dhermain, F.; French, Pim J.; Marosi, Christine; Watts, Colin; Oberg, Ingela; Pilkington, Geoffrey J.; Baumert, Brigitta G.; Taphoorn, Martin J.B.; Hegi, Monika E.; Westphal, Manfred; Reifenberger, Guido; Soffietti, Riccardo; Wick, Wolfgang

doi:10.1016/s1470-2045(17)30194-8

Cited by 915 publications

(728 citation statements)

References 82 publications

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“…Current median survival time for patients with oligodendrogliomas WHO grade III is 12-14 years, and longer for patients with oligodendroglioma WHO grade II [2]. Primary treatment is maximal safe resection, followed by radiotherapy and chemotherapy for highrisk patients [4,5]. Based on their chemosensitivity, it has recently been suggested that chemotherapy may be the optimal primary treatment for oligodendrogliomas [6].…”

Section: Introductionmentioning

confidence: 99%

Region-by-region analysis of PET, MRI, and histology in en bloc-resected oligodendrogliomas reveals intra-tumoral heterogeneity

Roodakker

Alhuseinalkhudhur

Al-Jaff

et al. 2018

Eur J Nucl Med Mol Imaging

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Purpose Oligodendrogliomas are heterogeneous tumors in terms of imaging appearance, and a deeper understanding of the histopathological tumor characteristics in correlation to imaging parameters is needed. We used PET-to-MRI-to-histology coregistration with the aim of studying intra-tumoral 11 C-methionine (MET) uptake in relation to tumor perfusion and the protein expression of histological cell markers in corresponding areas. Methods Consecutive histological sections of four tumors covering the entire en bloc-removed tumor were immunostained with antibodies against IDH1-mutated protein (tumor cells), Ki67 (proliferating cells), and CD34 (blood vessels). Software was developed for anatomical landmarks-based co-registration of subsequent histological images, which were overlaid on corresponding MET PET scans and MRI perfusion maps. Regions of interest (ROIs) on PET were selected throughout the entire tumor volume, covering hot spot areas, areas adjacent to hot spots, and tumor borders with infiltrating zone. Tumor-to-normal tissue (T/ N) ratios of MET uptake and mean relative cerebral blood volume (rCBV) were measured in the ROIs and protein expression of histological cell markers was quantified in corresponding regions. Statistical correlations were calculated between MET uptake, rCBV, and quantified protein expression. Results A total of 84 ROIs were selected in four oligodendrogliomas. A significant correlation (p < 0.05) between MET uptake and tumor cell density was demonstrated in all tumors separately. In two tumors, MET correlated with the density of proliferating cells and vessel cell density. There were no significant correlations between MET uptake and rCBV, and between rCBV and histological cell markers. Conclusions The MET uptake in hot spots, outside hotspots, and in infiltrating tumor edges unanimously reflects tumor cell density. The correlation between MET uptake and vessel density and density of proliferating cells is less stringent in infiltrating tumor edges and is probably more susceptible to artifacts caused by larger blood vessels surrounding the tumor. Although based on a limited number of samples, this study provides histological proof for MET as an indicator of tumor cell density and for the lack of statistically significant correlations between rCBV and histological cell markers in oligodendrogliomas.

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Section: Introductionmentioning

confidence: 99%

Region-by-region analysis of PET, MRI, and histology in en bloc-resected oligodendrogliomas reveals intra-tumoral heterogeneity

Roodakker

Alhuseinalkhudhur

Al-Jaff

et al. 2018

Eur J Nucl Med Mol Imaging

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“…6,7 In a study by Kaloshi et al from 2009, 8% of LGG diagnosed from 1997 and onwards occurred in patients 60 years or older. 9 For example, a more active surgical management for LGG is advocated nowadays, in contrast to earlier practice when potential undertreatment may have occurred. The overall survival in older patients was significantly impaired, which seemed related to an accumulation of negative prognostic factors in elderly patients and perhaps also due to undertreatment.…”

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confidence: 99%

Age and surgical outcome of low-grade glioma in Sweden

et al. 2018

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“…Despite the use of aggressive therapies, such as surgery, radiation therapy, chemotherapy, and anti‐angiogenic therapy, prognosis of gliomas remains poor . More importantly, therapeutic strategies vary among different grades, as well as different subtypes of glioma . Therefore, accurate determination of glioma grade and subtype needs to be addressed.…”

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confidence: 99%

Textural features of dynamic contrast‐enhanced MRI derived model‐free and model‐based parameter maps in glioma grading

Xie

Chen

Fang

et al. 2017

Magnetic Resonance Imaging

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European Association for Neuro-Oncology (EANO) guideline on the diagnosis and treatment of adult astrocytic and oligodendroglial gliomas

Cited by 915 publications

References 82 publications

Region-by-region analysis of PET, MRI, and histology in en bloc-resected oligodendrogliomas reveals intra-tumoral heterogeneity

Region-by-region analysis of PET, MRI, and histology in en bloc-resected oligodendrogliomas reveals intra-tumoral heterogeneity

Age and surgical outcome of low-grade glioma in Sweden

Textural features of dynamic contrast‐enhanced MRI derived model‐free and model‐based parameter maps in glioma grading

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