Jie Hu, Hongbo Bao, Xing Liu, Shengyu Fang, Zeya Yan, Zihan Wang, Renwu Zhang, Ruiyang Wang, Tingting Pu, Chao Li, Zaixu Cui, Tao Jiang, Yinyan Wang
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引用次数: 0
Abstract
Background: This study proposed a classification system for the interaction between gliomas and white matter tracts, exploring its potential associations with clinical characteristics, tumor pathological subtypes, and patient outcomes.
Methods: Clinical data and diffusion magnetic resonance imageing (dMRI) from 360 glioma patients who underwent craniotomy were analyzed. Using automatic fiber tractography, glioma-tract relationships were categorized into 3 types: displacement, infiltration, and disruption. Double immunohistochemical staining for isocitrate dehydrogenase (IDH) and myelin basic protein was performed on neuronavigation-guided tissue samples to validate the imaging-based classifications. The clinical implications of these classifications on the extent of tumor resection, postoperative motor function, and survival outcomes were evaluated.
Results: Among the patients, 35 (9.7%) were categorized as displacement type, 283 (78.6%) as infiltration type, and 42 (11.7%) as disruption type. Disruption-type tracts were predominantly associated with IDH wild-type gliomas (87.2%), significantly higher than infiltration (28.5%) and displacement types (23.5%) (P < .001). Displacement and infiltration types were more common in IDH-mutant gliomas (P < .001). Displacement-type tracts were significantly associated with higher rates of gross tumor resection compared to infiltration types (P = .015). In corticospinal tract involved cases, displacement-type tumors demonstrated no significant postoperative motor strength changes, whereas infiltration (P < .001) and disruption types (P = .013) were highly associated with postoperative motor deficits. Histological results aligned with dMRI-based classifications.
Conclusions: This dMRI-based classification of glioma-tract interactions is significantly associated with tumor pathology, resection outcomes, functional prognosis, and survival, providing a valuable tool for personalized and precise surgical planning.
期刊介绍：
Neuro-Oncology, the official journal of the Society for Neuro-Oncology, has been published monthly since January 2010. Affiliated with the Japan Society for Neuro-Oncology and the European Association of Neuro-Oncology, it is a global leader in the field.
The journal is committed to swiftly disseminating high-quality information across all areas of neuro-oncology. It features peer-reviewed articles, reviews, symposia on various topics, abstracts from annual meetings, and updates from neuro-oncology societies worldwide.
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