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Valenzuela-Fuenzalida JJ, Moyano-Valarezo L, Silva-Bravo V, Milos-Brandenberg D, Orellana-Donoso M, Nova-Baeza P, Suazo-Santibáñez A, Rodríguez-Luengo M, Oyanedel-Amaro G, Sanchis-Gimeno J, Gutiérrez Espinoza H. Association between the Anatomical Location of Glioblastoma and Its Evaluation with Clinical Considerations: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:3460. [PMID: 38929990 PMCID: PMC11204640 DOI: 10.3390/jcm13123460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/04/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Glioblastoma is a primary malignant brain tumor; it is aggressive with a high degree of malignancy and unfavorable prognosis and is the most common type of malignant brain tumor. Glioblastomas can be located in the brain, cerebellum, brainstem, and spinal cord, originating from glial cells, particularly astrocytes. Methods: The databases MEDLINE, Scopus, Web of Science, Google Scholar, and CINAHL were researched up to January 2024. Two authors independently performed the search, study selection, and data extraction. Methodological quality was evaluated with an assurance tool for anatomical studies (AQUA). The statistical mean, standard deviation, and difference of means calculated with the Student's t-test for presence between hemispheres and presence in the frontal and temporal lobes were analyzed. Results: A total of 123 studies met the established selection criteria, with a total of 6224 patients. In relation to the mean, GBM between hemispheres had a mean of 33.36 (SD 58.00) in the right hemisphere and a mean of 34.70 (SD 65.07) in the left hemisphere, due to the difference in averages between hemispheres. There were no statistically significant differences, p = 0.35. For the comparison between the presence of GBM in the frontal lobe and the temporal lobe, there was a mean in the frontal lobe of 23.23 (SD 40.03), while in the temporal lobe, the mean was 22.05 (SD 43.50), and for the difference in means between the frontal lobe and the temporal lobe, there was no statistically significant difference for the presence of GBM, p = 0.178. Conclusions: We believe that before a treatment, it will always be correct to know where the GBM is located and how it behaves clinically, in order to generate correct conservative or surgical treatment guidelines for each patient. We believe that more detailed studies are also needed to show why GBM is associated more with some regions than others, despite the brain structure being homologous to other regions in which GMB occurs less frequently, which is why knowing its predominant presence in brain regions is very important.
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Affiliation(s)
- Juan Jose Valenzuela-Fuenzalida
- Departamento de Ciencias Química y Biológicas, Facultad de Ciencias de la Salud, Universidad Bernardo O’Higgins, Santiago 8320000, Chile;
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (L.M.-V.); (V.S.-B.); (D.M.-B.); (P.N.-B.); (M.R.-L.)
| | - Laura Moyano-Valarezo
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (L.M.-V.); (V.S.-B.); (D.M.-B.); (P.N.-B.); (M.R.-L.)
| | - Vicente Silva-Bravo
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (L.M.-V.); (V.S.-B.); (D.M.-B.); (P.N.-B.); (M.R.-L.)
| | - Daniel Milos-Brandenberg
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (L.M.-V.); (V.S.-B.); (D.M.-B.); (P.N.-B.); (M.R.-L.)
- Escuela de Medicina, Facultad Ciencias de la Salud, Universidad del Alba, Santiago 8320000, Chile
| | - Mathias Orellana-Donoso
- Escuela de Medicina, Universidad Finis Terrae, Santiago 7501015, Chile;
- Department of Morphological Sciences, Faculty of Medicine and Science, Universidad San Sebastián, Santiago 8420524, Chile
| | - Pablo Nova-Baeza
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (L.M.-V.); (V.S.-B.); (D.M.-B.); (P.N.-B.); (M.R.-L.)
| | | | - Macarena Rodríguez-Luengo
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (L.M.-V.); (V.S.-B.); (D.M.-B.); (P.N.-B.); (M.R.-L.)
| | - Gustavo Oyanedel-Amaro
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago 8910060, Chile;
| | - Juan Sanchis-Gimeno
- GIAVAL Research Group, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Valencia, 46001 Valencia, Spain;
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Ashraf M, Abdelsadg M, Grivas A. Relationship between molecular characteristics of glioblastoma multiforme and the subventricular zone. Br J Neurosurg 2022:1-8. [PMID: 35038937 DOI: 10.1080/02688697.2021.2024144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/13/2021] [Accepted: 12/24/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVE This study aims to assess the relationship between the molecular characteristics of glioblastoma multiforme (GBM) and the subventricular zone (SVZ). MATERIAL AND METHODS Eligible patients had their data anonymously collected from an institutional database, including age, sex, preoperative performance status, the extent of tumour resection, anatomical location, IDH mutation and MGMT methylation status. An Institutional picture archiving and communications system was used for volumetric and morphometric analysis. All measurements were made on T1-weighted magnetic resonance images with gadolinium contrast enhancement. IDH wild-type and mutant GBMs were stratified by MGMT methylation status. The relationship between tumour volume, distance from the tumour's enhancing edge and the tumour's geometric centre to the SVZ and their molecular characteristics were assessed. RESULTS Fifty IDH wild-type GBMs were studied. Twenty-three were MGMT methylated, Twenty-seven were unmethylated. IDH wild-type MGMT methylated GBMs were significantly associated with a tumour's enhancing boundary being contiguous to the SVZ (P < 0.001). Ninety percent of tumours contiguous to the SVZ were wild-type methylated (n = 18) and 10% were unmethylated (n = 2). Mean GBM geometric centre distance to SVZ was significantly less for methylated wild-type GBMs compared to unmethylated (P = 0.025) and median GBM distance from the tumour's edge of enhancement to the SVZ was significantly shorter in methylated tumours compared to unmethylated (P < 0.001). Mean and median distances to SVZ from the edge of enhancement was 3.8 millimetres (mm) and 0 mm, respectively, for wild-type methylated GBMs, while for unmethylated wild-types, 14.6 mm, and 12.5 mm. There was no anatomical localisation of IDH wild-type GBMs by MGMT methylation status to a cerebral hemisphere or lobe. CONCLUSION IDH wild-type GBMs contiguous to the SVZ are highly likely to be MGMT methylated. Replication by further studies is required to affirm our results and conclusion.
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Affiliation(s)
- Mohammad Ashraf
- Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK
- Medical Student, Wolfson School of Medicine, University of Glasgow, Scotland, UK
| | - Mohamed Abdelsadg
- Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK
| | - Athanasios Grivas
- Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK
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3
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Butta S, Gupta MK. Immunohistochemical expression of MGMT in gliomas and its role in ascertaining patient survival. Med Pharm Rep 2021; 94:318-324. [PMID: 34430853 DOI: 10.15386/mpr-1951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/27/2020] [Accepted: 01/17/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction MGMT (O-6-methylguanine-DNA methyl transferase) is a DNA repair enzyme with implications on chemoresistance and subsequent patient prognosis. This study investigated the association of MGMT with the various grades and subtypes of gliomas and evaluated the associated clinical outcome of these patients. Methods This observational longitudinal follow up study spun over a period of 36 months and included 33 patients with primary glioma who underwent surgical interventions and chemoradiotherapy at a tertiary care center in Kolkata. The surgical samples were processed and histopathologically typed. Immunohistochemical analysis was done using anti-MGMT antibody and MGMT status was determined. Patients were followed up for 3 years. Results Males were 1.3 times more commonly affected by gliomas. Mean age was 42.9 years for females and 47.2 years for males. Frontal lobe was the most commonly involved site whereas focal neurological deficit was the most common symptom. Karnofsky performance score was higher for low grade gliomas and lower for high grade gliomas (p=0.04). Significant association was found between histopathological grade and MGMT immunoexpression (p=0.0001) as well as histopathological subtype and MGMT status (p=0.0036). On follow up, mean survival of the patients was 25.4 months. Significant association was found between MGMT status and survival of the patients (p=0.0437). Conclusion MGMT immunoexpression is significantly associated with different grades and subtypes of gliomas. In addition, MGMT has significant implications on chemoresistance and patient survival. Hence, MGMT expression should be mandatorily checked before starting the chemotherapy.
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Affiliation(s)
- Shristi Butta
- Department Pathology, NRS Medical College, Kolkata, West Bengal, India
| | - Manoj Kumar Gupta
- Department Tropical Medicine, Medical College, Kolkata, West Bengal, India
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Incekara F, van der Voort SR, Dubbink HJ, Atmodimedjo PN, Nandoe Tewarie R, Lycklama G, Vincent AJPE, Kros JM, Klein S, van den Bent M, Smits M. Topographical Mapping of 436 Newly Diagnosed IDH Wildtype Glioblastoma With vs. Without MGMT Promoter Methylation. Front Oncol 2020; 10:596. [PMID: 32477929 PMCID: PMC7235346 DOI: 10.3389/fonc.2020.00596] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 04/01/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction: O6-methylguanine-methyltransferase (MGMT) promoter methylation and isocitrate dehydrogenase (IDH) mutation status are important prognostic factors for patients with glioblastoma. There are conflicting reports about a differential topographical distribution of glioblastoma with vs. without MGMT promoter methylation, possibly caused by molecular heterogeneity in glioblastoma populations. We initiated this study to re-evaluate the topographical distribution of glioblastoma with vs. without MGMT promoter methylation in light of the updated WHO 2016 classification. Methods: Preoperative T2-weighted/FLAIR and postcontrast T1-weighted MRI scans of patients aged 18 year or older with IDH wildtype glioblastoma were collected. Tumors were semi-automatically segmented, and the topographical distribution between glioblastoma with vs. without MGMT promoter methylation was visualized using frequency heatmaps. Then, voxel-wise differences were analyzed using permutation testing with Threshold Free Cluster Enhancement. Results: Four hundred thirty-six IDH wildtype glioblastoma patients were included; 211 with and 225 without MGMT promoter methylation. Visual examination suggested that when compared with MGMT unmethylated glioblastoma, MGMT methylated glioblastoma were more frequently located near bifrontal and left occipital periventricular area and less frequently near the right occipital periventricular area. Statistical analyses, however, showed no significant difference in topographical distribution between MGMT methylated vs. MGMT unmethylated glioblastoma. Conclusions: This study re-evaluated the topographical distribution of MGMT promoter methylation in 436 newly diagnosed IDH wildtype glioblastoma, which is the largest homogenous IDH wildtype glioblastoma population to date. There was no statistically significant difference in anatomical localization between MGMT methylated vs. unmethylated IDH wildtype glioblastoma.
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Affiliation(s)
- Fatih Incekara
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC - University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Sebastian R van der Voort
- Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Hendrikus J Dubbink
- Department of Pathology, Brain Tumor Center at Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Peggy N Atmodimedjo
- Department of Pathology, Brain Tumor Center at Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | | | - Geert Lycklama
- Department of Radiology, Haaglanden MC, The Hague, Netherlands
| | - Arnaud J P E Vincent
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC - University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Johan M Kros
- Department of Pathology, Brain Tumor Center at Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Stefan Klein
- Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Martin van den Bent
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Marion Smits
- Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, Netherlands
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Imaging of Central Nervous System Tumors Based on the 2016 World Health Organization Classification. Neurol Clin 2020; 38:95-113. [DOI: 10.1016/j.ncl.2019.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Woodroffe RW, Zanaty M, Soni N, Mott SL, Helland LC, Pasha A, Maley J, Dhungana N, Jones KA, Monga V, Greenlee JDW. Survival after reoperation for recurrent glioblastoma. J Clin Neurosci 2020; 73:118-124. [PMID: 31987636 DOI: 10.1016/j.jocn.2020.01.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/30/2019] [Accepted: 01/04/2020] [Indexed: 10/25/2022]
Abstract
Determining which patients will benefit from reoperation for recurrent glioblastoma remains difficult and the impact of the volume of FLAIR signal hyperintensity is not well known. The primary purpose of this study is to analyze the impact of preoperative volume of FLAIR hyperintensity on prognosis. 37 patients who underwent a reoperation for recurrent glioblastoma after initial gross total resection followed by standard chemoradiation were retrospectively reviewed. Volumetric analysis of preoperative MR images from the initial and second surgery was performed and correlated with clinical data. Survival probabilities were estimated using the Kaplan-Meier method and Cox regression to assess the effect of risk factors on time to reoperation (TTR), progression-free survival (PFS) after reoperation, and overall survival (OS). The volumes of FLAIR signal hyperintensity prior to the initial surgery and reoperation were not associated with prognosis. TTR and OS were significantly affected by the preoperative enhancement volume at the initial surgery, with increasing volumes yielding poorer prognosis. Patients with tumor in critical/eloquent areas were found to have a worse prognosis. Median TTR was 11 months, median PFS after reoperation was 3 months, and OS in patients undergoing a reoperation was 21 months. The results suggest FLAIR signal change seen in patients with glioblastoma does not influence time to reoperation, progression-free survival, or overall survival. These findings suggest the amount of FLAIR signal change should not greatly influence a surgeon's decision to perform a second surgical resection compare to other factors, and when appropriate, aggressive surgical intervention should be considered.
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Affiliation(s)
- Royce W Woodroffe
- Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
| | - Mario Zanaty
- Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Neetu Soni
- Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Sarah L Mott
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
| | - Logan C Helland
- Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Arham Pasha
- Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Joan Maley
- Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Neha Dhungana
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Karra A Jones
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Varun Monga
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Jeremy D W Greenlee
- Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA
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Seow P, Wong JHD, Ahmad-Annuar A, Mahajan A, Abdullah NA, Ramli N. Quantitative magnetic resonance imaging and radiogenomic biomarkers for glioma characterisation: a systematic review. Br J Radiol 2018; 91:20170930. [PMID: 29902076 PMCID: PMC6319852 DOI: 10.1259/bjr.20170930] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 05/25/2018] [Accepted: 06/07/2018] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE: The diversity of tumour characteristics among glioma patients, even within same tumour grade, is a big challenge for disease outcome prediction. A possible approach for improved radiological imaging could come from combining information obtained at the molecular level. This review assembles recent evidence highlighting the value of using radiogenomic biomarkers to infer the underlying biology of gliomas and its correlation with imaging features. METHODS: A literature search was done for articles published between 2002 and 2017 on Medline electronic databases. Of 249 titles identified, 38 fulfilled the inclusion criteria, with 14 articles related to quantifiable imaging parameters (heterogeneity, vascularity, diffusion, cell density, infiltrations, perfusion, and metabolite changes) and 24 articles relevant to molecular biomarkers linked to imaging. RESULTS: Genes found to correlate with various imaging phenotypes were EGFR, MGMT, IDH1, VEGF, PDGF, TP53, and Ki-67. EGFR is the most studied gene related to imaging characteristics in the studies reviewed (41.7%), followed by MGMT (20.8%) and IDH1 (16.7%). A summary of the relationship amongst glioma morphology, gene expressions, imaging characteristics, prognosis and therapeutic response are presented. CONCLUSION: The use of radiogenomics can provide insights to understanding tumour biology and the underlying molecular pathways. Certain MRI characteristics that show strong correlations with EGFR, MGMT and IDH1 could be used as imaging biomarkers. Knowing the pathways involved in tumour progression and their associated imaging patterns may assist in diagnosis, prognosis and treatment management, while facilitating personalised medicine. ADVANCES IN KNOWLEDGE: Radiogenomics can offer clinicians better insight into diagnosis, prognosis, and prediction of therapeutic responses of glioma.
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Affiliation(s)
| | | | - Azlina Ahmad-Annuar
- Department of Biomedical Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Abhishek Mahajan
- Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Mumbai, India
| | - Nor Aniza Abdullah
- Department of Computer System and Technology, University of Malaya, Kuala Lumpur, Malaysia
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Dreher C, Oberhollenzer J, Meissner JE, Windschuh J, Schuenke P, Regnery S, Sahm F, Bickelhaupt S, Bendszus M, Wick W, Unterberg A, Zaiss M, Bachert P, Ladd ME, Schlemmer HP, Radbruch A, Paech D. Chemical exchange saturation transfer (CEST) signal intensity at 7T MRI of WHO IV° gliomas is dependent on the anatomic location. J Magn Reson Imaging 2018; 49:777-785. [PMID: 30133046 DOI: 10.1002/jmri.26215] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 05/23/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Chemical exchange saturation transfer (CEST) is a novel MRI technique applied to brain tumor patients. PURPOSE To investigate the anatomic location dependence of CEST MRI obtained at 7T and histopathological/molecular parameters in WHO IV° glioma patients. STUDY TYPE Analytic prospective study. POPULATION Twenty-one patients with newly diagnosed WHO IV° gliomas were studied prior to surgery; 11 healthy volunteers were investigated. FIELD STRENGTH/SEQUENCE Conventional MRI (contrast-enhanced, T2 w and diffusion-weighted imaging) at 3T and T2 w and CEST MRI at 7T was performed for patients and both patients and volunteers. ASSESSMENT Mean CEST signal intensities (nuclear-Overhauser-enhancement [NOE], amide-proton-transfer [APT], downfield NOE-suppressed APT [dns-APT]), ADC values, and histopathological/molecular parameters were evaluated with regard to hemisphere location and contact with the subventricular zone. CEST signal intensities of cerebral tissue of healthy volunteers were evaluated with regard to hemisphere discrimination. STATISTICAL TESTS Spearman correlation, Mann-Whitney U-test, Wilcoxon signed-rank-test, Fisher's exact test, and area under the receiver operating curve. RESULTS Maximum APT and dns-APT signal intensities were significantly different in right vs. left hemisphere gliomas (P = 0.037 and P = 0.007), but not in right vs. left hemisphere cerebral tissue of healthy subjects (P = 0.062-0.859). Mean ADC values were significantly decreased in right vs. left hemisphere gliomas (P = 0.044). Mean NOE signal intensity did not differ significantly between gliomas of either hemisphere (P = 0.820), but in case of subventricular zone contact (P = 0.047). A significant correlation was observed between APT and dns-APT and ADC signal intensities (rs = -0.627, P = 0.004 and rs = -0.534, P = 0.019), but not between NOE and ADC (rs = -0.341, P = 0.154). Histopathological/molecular parameters were not significantly different concerning the tumor location (P = 0.104-1.000, P = 0.286-0.696). DATA CONCLUSION APT, dns-APT, and ADC were inversely correlated and depended on the gliomas' hemisphere location. NOE showed significant dependence on subventricular zone contact. Location dependency of APT- and NOE-mediated CEST effects should be considered in clinical investigations of CEST MRI. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;49:777-785.
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Affiliation(s)
- Constantin Dreher
- German Cancer Research Center (DKFZ), Division of Radiology, Heidelberg, Germany
| | | | - Jan-Eric Meissner
- German Cancer Research Center (DKFZ), Division of Medical Physics in Radiology, Heidelberg, Germany
| | - Johannes Windschuh
- German Cancer Research Center (DKFZ), Division of Medical Physics in Radiology, Heidelberg, Germany.,Department of Radiology, New York University Langone Medical Center, New York, New York, USA
| | - Patrick Schuenke
- German Cancer Research Center (DKFZ), Division of Medical Physics in Radiology, Heidelberg, Germany
| | - Sebastian Regnery
- Department of Radiooncology, University Hospital Heidelberg, Heidelberg, Germany
| | - Felix Sahm
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany.,CCU Neuropathology, German Consortium for Translational Cancer Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Martin Bendszus
- Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Wolfgang Wick
- Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - Andreas Unterberg
- Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Moritz Zaiss
- Max-Planck-Institute for biological cybernetics, Magnetic Resonance Center, Tuebingen, Germany
| | - Peter Bachert
- German Cancer Research Center (DKFZ), Division of Medical Physics in Radiology, Heidelberg, Germany
| | - Mark E Ladd
- German Cancer Research Center (DKFZ), Division of Medical Physics in Radiology, Heidelberg, Germany.,Faculty of Physics and Astronomy, University of Heidelberg, Germany.,Faculty of Medicine, University of Heidelberg, Germany
| | | | - Alexander Radbruch
- German Cancer Research Center (DKFZ), Division of Radiology, Heidelberg, Germany
| | - Daniel Paech
- German Cancer Research Center (DKFZ), Division of Radiology, Heidelberg, Germany
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Molecular classification of patients with grade II/III glioma using quantitative MRI characteristics. J Neurooncol 2018; 139:633-642. [PMID: 29860714 DOI: 10.1007/s11060-018-2908-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 05/19/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Molecular markers of WHO grade II/III glioma are known to have important prognostic and predictive implications and may be associated with unique imaging phenotypes. The purpose of this study is to determine whether three clinically relevant molecular markers identified in gliomas-IDH, 1p/19q, and MGMT status-show distinct quantitative MRI characteristics on FLAIR imaging. METHODS Sixty-one patients with grade II/III gliomas who had molecular data and MRI available prior to radiation were included. Quantitative MRI features were extracted that measured tissue heterogeneity (homogeneity and pixel correlation) and FLAIR border distinctiveness (edge contrast; EC). T-tests were conducted to determine whether patients with different genotypes differ across the features. Logistic regression with LASSO regularization was used to determine the optimal combination of MRI and clinical features for predicting molecular subtypes. RESULTS Patients with IDH wildtype tumors showed greater signal heterogeneity (p = 0.001) and lower EC (p = 0.008) within the FLAIR region compared to IDH mutant tumors. Among patients with IDH mutant tumors, 1p/19q co-deleted tumors had greater signal heterogeneity (p = 0.002) and lower EC (p = 0.005) compared to 1p/19q intact tumors. MGMT methylated tumors showed lower EC (p = 0.03) compared to the unmethylated group. The combination of FLAIR border distinctness, heterogeneity, and pixel correlation optimally classified tumors by IDH status. CONCLUSION Quantitative imaging characteristics of FLAIR heterogeneity and border pattern in grade II/III gliomas may provide unique information for determining molecular status at time of initial diagnostic imaging, which may then guide subsequent surgical and medical management.
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Fan X, Qi C, Liu X, Wang Y, Liu S, Li S, Wang L, Wang Y. Regional specificity of matrix metalloproteinase-9 expression in the brain: voxel-level mapping in primary glioblastomas. Clin Radiol 2017; 73:283-289. [PMID: 29187298 DOI: 10.1016/j.crad.2017.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 10/04/2017] [Accepted: 10/17/2017] [Indexed: 11/27/2022]
Abstract
AIM To investigate the anatomical specificity of matrix metalloproteinase-9 (MMP-9) expression in glioblastomas by using voxel-based neuroimaging analysis. MATERIALS AND METHODS Clinical information and preoperative magnetic resonance images of 133 patients with glioblastomas were reviewed. Evaluation of MMP-9 expression was performed by using immunohistochemistry. Tumour lesions were segmented manually basing on the structural image of each patient, then registered to a standard brain atlas. Voxel-based regression analysis was subsequently performed to identify the specific brain regions that were associated with MMP-9 expression levels. RESULTS A significantly larger lesion volume of T2-hyperintensity was demonstrated in tumours with low MMP-9 expression compared to those with high MMP-9 expression (p=0.010). No significant difference was found in the lesion volumes of the contrast enhancement areas between the two groups (p=0.452). The major correlated cluster with high MMP-9 expression was identified in the right frontal lobe, while a cluster located at the posterior region of the right lateral ventricle was correlated with low MMP-9 expression. CONCLUSION Voxel-based statistical analysis revealed the anatomical specificity of MMP-9 expression levels in glioblastoma. The identified correlation between molecular biomarkers and anatomical distribution may increase our understanding of the biological characteristics of glioblastoma and provide new insight into the molecular subtypes of glioblastoma.
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Affiliation(s)
- X Fan
- Department of Neuroelectrophysiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China
| | - C Qi
- Department of Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China
| | - X Liu
- Department of Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, No. 6 Tiantan Xili, Beijing 100050, China
| | - Y Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - S Liu
- Department of Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, No. 6 Tiantan Xili, Beijing 100050, China
| | - S Li
- Department of Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China
| | - L Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China; China National Clinical Research Center for Neurological Diseases, China.
| | - Y Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
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Abstract
Primary brain tumors, most commonly gliomas, are histopathologically typed and graded as World Health Organization (WHO) grades I-IV according to increasing degrees of malignancy. These grades provide prognostic information and guidance on treatment such as radiation therapy and chemotherapy after surgery. Despite the confirmed value of the WHO grading system, results of a multitude of studies and prospective interventional trials now indicate that tumors with identical morphologic criteria can have highly different outcomes. Molecular markers can allow subtypes of tumors of the same morphologic type and WHO grade to be distinguished and are, therefore, of great interest in personalization of brain tumor treatment. Recent genomic-wide studies have resulted in a far more comprehensive understanding of the genomic alterations in gliomas and provide suggestions for a new molecularly based classification. Magnetic resonance (MR) imaging phenotypes can serve as noninvasive surrogates for tumor genotypes and can provide important information for diagnosis, prognosis, and, eventually, personalized treatment. The newly emerged field of radiogenomics allows specific MR imaging phenotypes to be linked with gene expression profiles. In this article, the authors review the conventional and advanced imaging features of three tumoral genotypes with prognostic and therapeutic consequences: (a) isocitrate dehydrogenase mutation; (b) the combined loss of the short arm of chromosome 1 and the long arm of chromosome 19, or 1p19q codeletion; and (c) methylguanine methyltransferase promoter methylation. © RSNA, 2017.
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Affiliation(s)
- Marion Smits
- From the Department of Radiology, Erasmus MC University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands (M.S.); and Brain Tumor Center, Erasmus MC Cancer Center, Rotterdam, the Netherlands (M.J.v.d.B.)
| | - Martin J van den Bent
- From the Department of Radiology, Erasmus MC University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands (M.S.); and Brain Tumor Center, Erasmus MC Cancer Center, Rotterdam, the Netherlands (M.J.v.d.B.)
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Impact of removed tumor volume and location on patient outcome in glioblastoma. J Neurooncol 2017; 135:161-171. [PMID: 28685405 DOI: 10.1007/s11060-017-2562-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 06/25/2017] [Indexed: 10/19/2022]
Abstract
Glioblastoma is an aggressive primary brain tumor with devastatingly poor prognosis. Multiple studies have shown the benefit of wider extent of resection (EOR) on patient overall survival (OS) and worsened survival with larger preoperative tumor volumes. However, the concomitant impact of postoperative tumor volume and eloquent location on OS has yet to be fully evaluated. We performed a retrospective chart review of adult patients treated for glioblastoma from January 2006 through December 2011. Adherence to standardized postoperative chemoradiation protocols was used as an inclusion criterion. Detailed volumetric and location analysis was performed on immediate preoperative and immediate postoperative magnetic resonance imaging. Cox proportional hazard modeling approach was employed to explore the modifying effects of EOR and eloquent location after adjusting for various confounders and associated characteristics, such as preoperative tumor volume and demographics. Of the 471 screened patients, 141 were excluded because they did not meet all inclusion criteria. The mean (±SD) age of the remaining 330 patients (60.6% male) was 58.9 ± 12.9 years; the mean preoperative and postoperative Karnofsky performance scores (KPSs) were 76.2 ± 10.3 and 80.0 ± 16.6, respectively. Preoperative tumor volume averaged 33.2 ± 29.0 ml, postoperative residual was 4.0 ± 8.1 ml, and average EOR was 88.6 ± 17.6%. The observed average follow-up was 17.6 ± 15.7 months, and mean OS was 16.7 ± 14.4 months. Survival analysis showed significantly shorter survival for patients with lesions in periventricular (16.8 ± 1.7 vs. 21.5 ± 1.4 mo, p = 0.03), deep nuclei/basal ganglia (11.6 ± 1.7 vs. 20.6 ± 1.2, p = 0.002), and multifocal (12.0 ± 1.4 vs. 21.3 ± 1.3 months, p = 0.0001) locations, but no significant influence on survival was seen for eloquent cortex sites (p = 0.14, range 0.07-0.9 for all individual locations). OS significantly improved with EOR in univariate analysis, averaging 22.3, 19.7, and 13.2 months for >90, 80-90, and 70-80% resection, respectively. Survival was 22.8, 19.0, and 12.7 months for 0, 0-5, and 5-10 ml postoperative residual, respectively. A hazard model showed that larger preoperative tumor volume [hazard ratio (HR) 1.05, 95% CI 1.02-1.07], greater age (HR 1.02, 95% CI 1.01-1.03), multifocality (HR 1.44, 95% CI 1.01-2.04), and deep nuclei/basal ganglia (HR 2.05, CI 1.27-3.3) were the most predictive of poor survival after adjusting for KPS and tumor location. There was a negligible but significant interaction between EOR and preoperative tumor volume (HR 0.9995, 95% CI 0.9993-0.9998), but EOR alone did not correlate with OS after adjusting for other factors. The interaction between EOR and preoperative tumor volume represented tumor volume removed during surgery. In conclusion, EOR alone was not an important predictor of outcome during GBM treatment once preoperative tumor volume, age, and deep nuclei/basal ganglia location were factored. Instead, the interaction between EOR and preoperative volume, representing reduced disease burden, was an important predictor of reducing OS. Removal of tumor from eloquent cortex did not impact postoperative KPS. These results suggest aggressive surgical treatment to reduce postoperative residual while maintaining postoperative KPS may aid patient survival outcomes for a given tumor size and location.
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Darlix A, Deverdun J, Menjot de Champfleur N, Castan F, Zouaoui S, Rigau V, Fabbro M, Yordanova Y, Le Bars E, Bauchet L, Gozé C, Duffau H. IDH mutation and 1p19q codeletion distinguish two radiological patterns of diffuse low-grade gliomas. J Neurooncol 2017; 133:37-45. [PMID: 28434111 DOI: 10.1007/s11060-017-2421-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 04/09/2017] [Indexed: 02/06/2023]
Abstract
Diffuse low-grade gliomas (DLGG) prognosis is variable, depending on several factors, including the isocitrate dehydrogenase (IDH) mutation and the 1p19q codeletion. A few studies suggested associations between these parameters and tumor radiological characteristics including topography. Our aim was analyzing the correlations between the IDH and 1p19q statuses and the tumor intracerebral distribution (at the lobar and voxel levels), volume, and borders. We conducted a retrospective, monocentric study on a consecutive series of 198 DLGG patients. The IDH and 1p19q statuses were recorded. The pre-treatment magnetic resonance FLAIR imagings were reviewed for determination of lobar topography, tumor volume, and characterisation of tumor borders (sharp or indistinct). We conducted a voxel-based lesion-symptom mapping analysis to investigate the correlations between the IDH and 1p19q statuses and topography at the voxel level. The IDH mutation and 1p19q statuses were correlated with the tumor topography defined using lobar anatomy (p < 0.001 and p = 0.004, respectively). Frontal tumors were more frequently IDH-mutant (87.1 vs. 57.4%) and 1p19q codeleted (45.2 vs. 17.0%) than temporo-insular lesions. At the voxel level, these associations were not found. Tumors with sharp borders were more frequently IDH-mutant (p = 0.001) while tumors with indistinct borders were more frequently IDH wild-type and 1p19q non-codeleted (p < 0.001). Larger tumors at diagnosis (possibly linked to a slower growth rate) were more frequently IDH-mutant (p < 0.001). IDH wild-type, 1p19q non-codeleted temporo-insular tumors are distinct from IDH-mutant, 1p19q codeleted frontal tumors. Further studies are needed to determine whether the therapeutic strategy should be adapted to each pattern.
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Affiliation(s)
- Amélie Darlix
- Department of Medical Oncology, Institut Régional du Cancer de Montpellier (ICM) - Val d'Aurelle, 208 Rue des Apothicaires, 34298, Montpellier, France. .,INSERM U1051, Montpellier Neurosciences Institute, 80 Avenue Augustin Fliche, 34091, Montpellier, France.
| | - Jérémy Deverdun
- Department of Neuroradiology, Gui de Chauliac Hospital, 80 Avenue Augustin Fliche, 34090, Montpellier, France
| | | | - Florence Castan
- Biometrics Unit, Institut Régional du Cancer de Montpellier (ICM) - Val d'Aurelle, 208 Rue des Apothicaires, 34298, Montpellier, France
| | - Sonia Zouaoui
- Department of Epidemiology, French Brain Tumor Database, GNOLR, Registre des Tumeurs de l'Hérault, Institut Régional du Cancer de Montpellier (ICM) - Val d'Aurelle, 208 Rue des Apothicaires, 34298, Montpellier, France.,Department of Neurosurgery, Gui de Chauliac Hospital, 80 Avenue Augustin Fliche, 34090, Montpellier, France
| | - Valérie Rigau
- Department of Pathology, Gui de Chauliac Hospital, 80 Avenue Augustin Fliche, 34090, Montpellier, France
| | - Michel Fabbro
- Department of Medical Oncology, Institut Régional du Cancer de Montpellier (ICM) - Val d'Aurelle, 208 Rue des Apothicaires, 34298, Montpellier, France
| | - Yordanka Yordanova
- INSERM U1051, Montpellier Neurosciences Institute, 80 Avenue Augustin Fliche, 34091, Montpellier, France.,Department of Neurosurgery, Percy Military Hospital, 101 Avenue Henri Barbusse, 92140, Clamart, France
| | - Emmanuelle Le Bars
- Department of Neuroradiology, Gui de Chauliac Hospital, 80 Avenue Augustin Fliche, 34090, Montpellier, France
| | - Luc Bauchet
- INSERM U1051, Montpellier Neurosciences Institute, 80 Avenue Augustin Fliche, 34091, Montpellier, France.,Department of Neurosurgery, Gui de Chauliac Hospital, 80 Avenue Augustin Fliche, 34090, Montpellier, France
| | - Catherine Gozé
- INSERM U1051, Montpellier Neurosciences Institute, 80 Avenue Augustin Fliche, 34091, Montpellier, France.,Laboratory of Cellular and Tumoral Biology, Biopathology Department, Arnaud de Villeneuve Hospital, 371 Avenue du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Hugues Duffau
- INSERM U1051, Montpellier Neurosciences Institute, 80 Avenue Augustin Fliche, 34091, Montpellier, France.,Department of Neurosurgery, Gui de Chauliac Hospital, 80 Avenue Augustin Fliche, 34090, Montpellier, France
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Frontal glioblastoma multiforme may be biologically distinct from non-frontal and multilobar tumors. J Clin Neurosci 2016; 34:128-132. [PMID: 27593971 DOI: 10.1016/j.jocn.2016.05.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 05/20/2016] [Indexed: 11/21/2022]
Abstract
Glioblastoma multiforme (GBM) is the most common primary brain tumor in adults and carries a grim prognosis. Lobar GBM, notably those localized to the frontal lobe, are generally more amenable to complete surgical resection, and may carry a better prognosis. The biology of differently localized GBM has been reported scarcely in terms of prognostic markers, including isocitrate dehydrogenase 1 (IDH1) mutation and O(6)-methylguanine-methyltransferase (MGMT) methylation. To our knowledge, there has been no evaluation in the literature of different proliferation indexes in different GBM locations in the brain. We performed a retrospective evaluation of our prospectively collected database to assess the rate of IDH1 positivity, MGMT methylation and Ki67 index for GBM located in the frontal lobes alone, lobar GBM in other supra-tentorial lobes and multilobar GBM. IDH1 mutated tumors were localized in the frontal lobes in 50.0%, whereas only 20.3% of IDH1 wild-type tumors were localized in the frontal lobe (p=0.006); MGMT methylated tumors were localized in the frontal lobe in 32.0% of the cases. Only 13.75% of the MGMT unmethylated tumors were localized to the frontal lobe (p=0.005); Tumors with higher Ki67 proliferation index were more likely to be localized in the frontal lobe (40.6% vs. 19.5%, p=0.019). This is the largest cohort of GBM assessed for these purposes in the literature. Frontal lobe GBMs may be intrinsically biologically distinct from GBM in other lobes and from multilobar tumors.
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Fan X, Wang Y, Liu Y, Liu X, Zhang C, Wang L, Li S, Ma J, Jiang T. Brain regions associated with telomerase reverse transcriptase promoter mutations in primary glioblastomas. J Neurooncol 2016; 128:455-62. [DOI: 10.1007/s11060-016-2132-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 04/18/2016] [Indexed: 12/29/2022]
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16
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Loss of ATRX, associated with DNA methylation pattern of chromosome end, impacted biological behaviors of astrocytic tumors. Oncotarget 2016; 6:18105-15. [PMID: 25971279 PMCID: PMC4627238 DOI: 10.18632/oncotarget.3906] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 04/24/2015] [Indexed: 12/31/2022] Open
Abstract
Loss of ATRX leads to epigenetic alterations, including abnormal levels of DNA methylation at repetitive elements such as telomeres in murine cells. We conducted an extensive DNA methylation and mRNA expression profile study on a cohort of 82 patients with astrocytic tumors to study whether ATRX expression was associated with DNA methylation level in astrocytic tumors and in which cellular functions it participated. We observed that astrocytic tumors with lower ATRX expression harbored higher DNA methylation level at chromatin end and astrocytic tumors with ATRX-low had distinct gene expression profile and DNA methylation profile compared with ATRX-high tumors. Then, we uncovered that several ATRX associated biological functions in the DNA methylation and mRNA expression profile (GEP), including apoptotic process, DNA-dependent positive regulation of transcription, chromatin modification, and observed that ATRX expression was companied by MGMT methylation and expression. We also found that loss of ATRX caused by siRNA induced apoptotic cells increasing, reduced tumor cell proliferation and repressed the cell migration in glioma cells. Our results showed ATRX-related regulatory functions of the combined profiles from DNA methylation and mRNA expression in astrocytic tumors, and delineated that loss of ATRX impacted biological behaviors of astrocytic tumor cells, providing important resources for future dissection of ATRX role in glioma.
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Fan X, Wang Y, Wang K, Liu S, Liu Y, Ma J, Li S, Jiang T. Anatomical specificity of vascular endothelial growth factor expression in glioblastomas: a voxel-based mapping analysis. Neuroradiology 2015; 58:69-75. [PMID: 26453565 DOI: 10.1007/s00234-015-1602-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 09/28/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The expression of vascular endothelial growth factor (VEGF) is a common genetic alteration in malignant gliomas and contributes to the angiogenesis of tumors. This study aimed to investigate the anatomical specificity of VEGF expression levels in glioblastomas using voxel-based neuroimaging analysis. METHODS Clinical information, MR scans, and immunohistochemistry stains of 209 patients with glioblastomas were reviewed. All tumor lesions were segmented manually and subsequently registered to standard brain space. Voxel-based regression analysis was performed to correlate the brain regions of tumor involvement with the level of VEGF expression. Brain regions identified as significantly associated with high or low VEGF expression were preserved following permutation correction. RESULTS High VEGF expression was detected in 123 (58.9 %) of the 209 patients. Voxel-based statistical analysis demonstrated that high VEGF expression was more likely in tumors located in the left frontal lobe and the right caudate and low VEGF expression was more likely in tumors that occurred in the posterior region of the right lateral ventricle. CONCLUSION Voxel-based neuroimaging analysis revealed the anatomic specificity of VEGF expression in glioblastoma, which may further our understanding of genetic heterogeneity during tumor origination. This finding provides primary theoretical support for potential future application of customized antiangiogenic therapy.
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Affiliation(s)
- Xing Fan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing, 100050, People's Republic of China
| | - Yinyan Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing, 100050, People's Republic of China.,Department of Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People's Republic of China
| | - Kai Wang
- Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Shuai Liu
- Departments of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yong Liu
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Jun Ma
- Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Shaowu Li
- Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
| | - Tao Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing, 100050, People's Republic of China. .,Department of Clinical Oncology, Beijing Academy of Critical Illness in Brain, Beijing, People's Republic of China.
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Wang Y, Liu S, Fan X, Li S, Wang R, Wang L, Ma J, Jiang T, Ma W. Age-associated brain regions in gliomas: a volumetric analysis. J Neurooncol 2015; 123:299-306. [PMID: 25981802 DOI: 10.1007/s11060-015-1798-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 04/20/2015] [Indexed: 01/29/2023]
Abstract
Both age of patients and tumor location are associated with tumor origin, genetic characteristics, and prognosis. The objective of this study was to investigate the relationship between tumor location and age at diagnosis in a large cohort of patients with a primary diagnosis of glioma. We consecutively enrolled a cohort of 200 adults with glioblastoma and another cohort of 200 adults with diffuse low-grade gliomas. The magnetic resonance images of all tumors were manually segmented and then registered to a standard brain space. By using voxel-by-voxel regression analysis, specific brains regions associated with advanced age at tumor diagnosis were localized. In the low-grade gliomas cohort, the brain regions associated with advanced age at tumor diagnosis were mainly located in the right middle frontal region, while a region in the left temporal lobe, particularly at the subgranular zone, was associated with lower age at tumor diagnosis. In the glioblastoma cohort, the brain regions associated with advanced age at tumor diagnosis were mainly located in the temporal lobe, particularly at the posterior region of the subventricular zones. A region in the left inferior frontal region was associated with lower age at tumor diagnosis. Significant differences in the age of patients were found between tumors located in the identified regions and those located elsewhere in both cohorts. The current study demonstrated the correlation between tumor location and age at diagnosis, which implies differences in the origin of gliomas in young and older patients.
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Affiliation(s)
- Yinyan Wang
- Beijing Neurosurgical Institute, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing, 100050, China
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