Prognostic significance of MRI contrast enhancement in newly diagnosed glioblastoma, IDH-wildtype according to WHO 2021 classification.

IF 3.2 2区 医学 Q2 CLINICAL NEUROLOGY Journal of Neuro-Oncology Pub Date : 2024-09-01 Epub Date: 2024-06-24 DOI:10.1007/s11060-024-04747-7
Alexandre Roux, Angela Elia, Benoit Hudelist, Joseph Benzakoun, Edouard Dezamis, Eduardo Parraga, Alessandro Moiraghi, Giorgia Antonia Simboli, Fabrice Chretien, Catherine Oppenheim, Marc Zanello, Johan Pallud
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Abstract

Background and objectives: Contrast enhancement in glioblastoma, IDH-wildtype is common but not systematic. In the era of the WHO 2021 Classification of CNS Tumors, the prognostic impact of a contrast enhancement and the pattern of contrast enhancement is not clearly elucidated.

Methods: We performed an observational, retrospective, single-centre cohort study at a tertiary neurosurgical oncology centre (January 2006 - December 2022). We screened adult patients with a newly-diagnosed glioblastoma, IDH-wildtype in order to assess the prognosis role of the contrast enhancement and the pattern of contrast enhancement.

Results: We included 1149 glioblastomas, IDH-wildtype: 26 (2.3%) had a no contrast enhancement, 45 (4.0%) had a faint and patchy contrast enhancement, 118 (10.5%) had a nodular contrast enhancement, and 960 (85.5%) had a ring-like contrast enhancement. Overall survival was longer in non-contrast enhanced glioblastomas (26.7 months) than in contrast enhanced glioblastomas (10.9 months) (p < 0.001). In contrast enhanced glioblastomas, a ring-like pattern was associated with shorter overall survival than in faint and patchy and nodular patterns (10.0 months versus 13.0 months, respectively) (p = 0.033). Whatever the presence of a contrast enhancement and the pattern of contrast enhancement, surgical resection was an independent predictor of longer overall survival, while age ≥ 70 years, preoperative KPS score < 70, tumour volume ≥ 30cm3, and postoperative residual contrast enhancement were independent predictors of shorter overall survival.

Conclusion: A contrast enhancement is present in the majority (97.7%) of glioblastomas, IDH-wildtype and, regardless of the pattern, is associated with a shorter overall survival. The ring-like pattern of contrast enhancement is typical in glioblastomas, IDH-wildtype (85.5%) and remains an independent predictor of shorter overall survival compared to other patterns (faint and patchy and nodular).

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根据世界卫生组织 2021 年的分类,新诊断的 IDH 野生型胶质母细胞瘤 MRI 对比增强的预后意义。
背景和目的:IDH-野生型胶质母细胞瘤的对比度增强很常见,但并不系统。在世界卫生组织《中枢神经系统肿瘤 2021 年分类》时代,对比度增强对预后的影响以及对比度增强的模式尚未明确阐明:我们在一家三级神经外科肿瘤中心进行了一项观察性、回顾性、单中心队列研究(2006 年 1 月至 2022 年 12 月)。我们筛选了新诊断为IDH-野生型胶质母细胞瘤的成年患者,以评估对比度增强的预后作用和对比度增强的模式:我们纳入了1149例IDH-野生型胶质母细胞瘤:26例(2.3%)无对比度增强,45例(4.0%)对比度增强模糊且呈斑片状,118例(10.5%)对比度增强呈结节状,960例(85.5%)对比度增强呈环状。非造影剂增强型胶质母细胞瘤的总生存期(26.7 个月)长于造影剂增强型胶质母细胞瘤(10.9 个月)(P.3),术后残留造影剂增强是总生存期缩短的独立预测因素:结论:大多数(97.7%)IDH-野生型胶质母细胞瘤都存在对比度增强,而且无论对比度增强的模式如何,都与较短的总生存期有关。IDH-野生型胶质母细胞瘤(85.5%)的典型对比度增强模式为环状,与其他模式(模糊、斑块状和结节状)相比,环状对比度增强仍是缩短总生存期的独立预测因素。
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来源期刊
Journal of Neuro-Oncology
Journal of Neuro-Oncology 医学-临床神经学
CiteScore
6.60
自引率
7.70%
发文量
277
审稿时长
3.3 months
期刊介绍: The Journal of Neuro-Oncology is a multi-disciplinary journal encompassing basic, applied, and clinical investigations in all research areas as they relate to cancer and the central nervous system. It provides a single forum for communication among neurologists, neurosurgeons, radiotherapists, medical oncologists, neuropathologists, neurodiagnosticians, and laboratory-based oncologists conducting relevant research. The Journal of Neuro-Oncology does not seek to isolate the field, but rather to focus the efforts of many disciplines in one publication through a format which pulls together these diverse interests. More than any other field of oncology, cancer of the central nervous system requires multi-disciplinary approaches. To alleviate having to scan dozens of journals of cell biology, pathology, laboratory and clinical endeavours, JNO is a periodical in which current, high-quality, relevant research in all aspects of neuro-oncology may be found.
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