Incidence and prognostic significance of non‐enhancing cortical signal abnormality in glioblastoma

Abstract

Non-enhancing cortical signal abnormality is a common feature of glioblastomas, occurring in about half of cases. It does not affect survival overall, but appears to be associated with worse survival in the setting of a peripherally located enhancing lesion. This has the potential to alter surgical management.

18F-FDOPA PET and MRI characteristics correlate with degree of malignancy and predict survival in treatment-naïve gliomas: a cross-sectional study

“…In a prospective study of 16 glioma patients with <10% MRI CE tumor volume who also underwent preoperative 11C-methionine PET and 18F-FDG PET, the tissue from lesions positive for CE, T2 hyperintensity, 11C-methionine signal, and 18F-FDG signal gave an accurate diagnosis of grade in only 40% of cases [36]. Taken together with previous investigations[6, 7], these studies highlight the diagnostic dilemma of determining high-grade glioma based on MRI alone, or in combination with 11C-methionine PET and 18F-FDG PET, in the newly-diagnosed setting. Results from the current study suggest combined information from both MRI and 18 F-FDOPA PET may improve this prediction.…”

“…According to the Central Brain Tumor Registry of the United States, the 1995–2012 survival rates for patients with GBM were 37.2% and 5.1% at 1-year and 5-years after diagnosis, respectively [1], and median survival for GBM is approximately 12–16 months [2–4]. At initial presentation, contrast-enhancement (CE) on the magnetic resonance imaging (MRI) scan, the gold standard for diagnosis and response assessment in malignant gliomas [5], may suggest a high-grade glioma (HGG), and up to 51% of newly-diagnosed GBMs may contain non-enhancing cortical signal abnormality [6]. In a prospective study of 53 newly-diagnosed brain tumor patients with non-CE lesions on MRI, 34% were found to have histologically-proven high-grade glioma [7].…”

MRI Features Can Predict 1p/19q Status in Intracranial Gliomas

“…In addition, it is likely to be the least specific feature, especially in smaller tumors, because cortical involvement is also frequently present in astrocytomas. 20,21 These limitations of the cortical involvement variable account for some of the inaccuracies in the overall prediction of 1p/19q status. We also assessed the 2 possible thresholds of Ͼ50% or Ͼ33% for the proportions of T2-FLAIR mismatch and cortical involvement.…”

Deep learning for glioblastoma segmentation using preoperative magnetic resonance imaging identifies volumetric features associated with survival

“…The association between FLAIR proportion relative to other subregions and survival is unclear [38]. PTE/TC was not found to be associated with OS in a previous study [34].…”