Predicting Genotype and Survival in Glioma Using Standard Clinical MR Imaging Apparent Diffusion Coefficient Images: A Pilot Study from The Cancer Genome Atlas

Wu, Chao‐Hsiung; Jain, Rajan; Radmanesh, Alireza; Poisson, Laila; Guo, Wan‐Yuo; Zagzag, David; Snuderl, Matija; Placantonakis, Dimitris G.; Golfinos, John G.; Chi, Andrew

doi:10.3174/ajnr.a5794

Cited by 60 publications

(48 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We hypothesize that with many patients undergoing CT at diagnosis, consistent availability of this and/or SWI imaging could further increase observer certainty and concordance. In keeping with our observations (model B), absence of cysts has been proposed previously as an IDH wt glioma feature (33).…”

Section: Test Samplesupporting

confidence: 92%

World Health Organization Grade II/III Glioma Molecular Status: Prediction by MRI Morphologic Features and Apparent Diffusion Coefficient

Maynard¹,

Okuchi

Wastling³

et al. 2020

Radiology

View full text Add to dashboard Cite

An algorithm based on standard MRI sequences and age predicted isocitrate dehydrogenase status in lower grade gliomas with comparable accuracy to advanced MRI sequences and computational methods. Key results • Apparent diffusion coefficient (ADC) measurements (minimum, mean) and their ratios to normal appearing white matter were reproducible (intraclass correlation coefficient 0.83-0.96) and distinguished three lower grade glioma subtypes: isocitrate dehydrogenase (IDH) wild-type, IDH mutant/1p19q intact, and IDH mutant/1p19q co-deleted (p<0.001). • A negative association (β 0.09, Pseudo R 2 0.34) was identified between age and IDH mutations (p<0.001). Glioma location, enhancement characteristics, calcification, and cyst formation were univariable and multivariable predictors of IDH genotype. • Two predictive models incorporating ADC, age and morphology defined IDH genotype with accuracies of 92% and 91% (AUC 0.94-0.96). Commented [BE1]: Thank you for your revision. Most of the reviewers' comments have been addressed. There are a few remaining issues, though. Please see the reviewers' comments and the attached document with changes tracked. If you agree with these changes, please accept them. If you disagree, please annotate your responses. Deleted: clinically relevant Deleted: modalities Commented [BE2]: Or did you really mean other modalities, e.g. PET? Commented [WU3]: Please include numerical data in addition to p values.

show abstract

Section: Test Samplesupporting

confidence: 92%

World Health Organization Grade II/III Glioma Molecular Status: Prediction by MRI Morphologic Features and Apparent Diffusion Coefficient

Maynard¹,

Okuchi

Wastling³

et al. 2020

Radiology

View full text Add to dashboard Cite

show abstract

“…ADC values obtained from standard clinical DWI with a simple, two-dimensional region-of-interest (ROI) quantification were lower in IDH wild-type than in IDH-mutant LGG, thus supporting the importance of the extraction of quantitative, radiomic metrics for meaningful dMRI analysis [ 36 ]. More recently, a pilot study from The Cancer Genome Atlas has demonstrated that ADC values obtained from clinical DWI correlated with survival in patients with IDH-mutant and IDH wild-type gliomas regardless of WHO grade, suggesting a potential usefulness of quantitative ADC estimates as a prognostic marker to enhance risk stratification in brain gliomas [ 37 ].…”

Section: Imagingmentioning

confidence: 99%

Clinical Management of Diffuse Low-Grade Gliomas

Lombardi

Barresi

Castellano

et al. 2020

Cancers

View full text Add to dashboard Cite

Diffuse low-grade gliomas (LGG) represent a heterogeneous group of primary brain tumors arising from supporting glial cells and usually affecting young adults. Advances in the knowledge of molecular profile of these tumors, including mutations in the isocitrate dehydrogenase genes, or 1p/19q codeletion, and in neuroradiological techniques have contributed to the diagnosis, prognostic stratification, and follow-up of these tumors. Optimal post-operative management of LGG is still controversial, though radiation therapy and chemotherapy remain the optimal treatments after surgical resection in selected patients. In this review, we report the most important and recent research on clinical and molecular features, new neuroradiological techniques, the different therapeutic modalities, and new opportunities for personalized targeted therapy and supportive care.

show abstract

“…Our study is not dependent on advanced sequences, we used only the basic sequences with diffusion weighted imaging (DWI) sequence to classify the gliomas. A pilot study by Wu et al have tried using DWI imaging to predict survival, but it is dependent on IDH mutation (22) . Thus, none of the study have looked holistically at gliomas to come up with a radiological classification system independent of the histological and genetic information.…”

Section: Discussionmentioning

confidence: 99%

New Radiological Classification of Glioma and validation with the survival analysis

Kamble

Agrawal

Koundal

et al. 2020

Preprint

View full text Add to dashboard Cite

Radiology based classification of glioma independent of histological or genetic markers predicting survival of patients is an unmet need. Until now radiology is chasing these markers rather than focussing directly on the clinical outcome. Our study is first of its kind to come up with the independent new radiological classification of gliomas encompassing both low-and high-grade gliomas under single classification system. TCGA-LGG and REMBRANDT public domain dataset of glioma were analyzed as training and testing dataset respectively. Based on MRI images, gliomas were classified into six types in detailed classification & three types in simplified classification system. Survival analysis using Kaplan Meier and Cox regression was done. Secondary objective was to evaluate the sensitivity and specificity of novel signs with existing histological and genetic markers. The study predicted survival in both training and testing dataset independent of genetic or histological information. Novel signs, "Ball on Christmas tree" sign(highly specific), Type-4 lineage sign(highly sensitive) identifies IDH-wild and high-grade gliomas (grade-III and IV) while Type-2 lineage sign showed good specificity in identifying 1p19q non co-deleted IDH-mutated, ATRX del/mutated, Grade-II gliomas. There is a substantial interobserver agreement for the classification and novel signs. New radiological classification of glioma predicts the survival of patients independent of genetic or histological information. This can act as a scaffolding to formulate and streamline the treatment guidelines for glioma patients. This classification has potential of improving the quality of care of glioma patients by predicting the survival without the need of invasive biopsy.

show abstract

Predicting Genotype and Survival in Glioma Using Standard Clinical MR Imaging Apparent Diffusion Coefficient Images: A Pilot Study from The Cancer Genome Atlas

Abstract: wild-type glioma showed lower ADC values, which also correlated with poor survival in both -mutant and wild-type gliomas, irrespective of histologic grade. A subgroup with -mutant gliomas with lower ADC had dismal survival similar to that of those with wild-type gliomas.

Cited by 60 publications

References 39 publications

World Health Organization Grade II/III Glioma Molecular Status: Prediction by MRI Morphologic Features and Apparent Diffusion Coefficient

World Health Organization Grade II/III Glioma Molecular Status: Prediction by MRI Morphologic Features and Apparent Diffusion Coefficient

Clinical Management of Diffuse Low-Grade Gliomas

New Radiological Classification of Glioma and validation with the survival analysis

Contact Info

Product

Resources

About