1. Prognostic relevance of gemistocytic grade II astrocytoma: gemistocytic component and MR imaging features compared to non-gemistocytic grade II astrocytoma.
- Author
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Heo, Young, Park, Ji, Kim, Ho, Lee, Ji, Nam, Soo, Jung, Seung, Choi, Choong, Kim, Sang, Heo, Young Jin, Park, Ji Eun, Kim, Ho Sung, Lee, Ji Ye, Nam, Soo Jeong, Jung, Seung Chai, Choi, Choong Gon, and Kim, Sang Joon
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ASTROCYTOMAS , *TUMOR grading , *DISEASE progression , *TUMORS , *HISTOPATHOLOGY , *CONTRAST-enhanced magnetic resonance imaging , *PROGNOSIS , *MAGNETIC resonance imaging , *BRAIN tumors , *COMPARATIVE studies , *GLIOMAS , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL cooperation , *NUCLEAR magnetic resonance spectroscopy , *RESEARCH , *TIME , *EVALUATION research , *RETROSPECTIVE studies - Abstract
Objectives: To determine if gemistocytic grade II astrocytoma (GemA) and its MR imaging characteristics are associated with a shorter time-to-progression (TTP) compared with non-gemistocytic grade II astrocytoma (non-GemA).Materials and Methods: We enrolled 78 patients who were followed up more than 5 years (29 pathologically proven GemA and 49 non-GemA) during a 10-year period. Contrast-enhanced T1-weighted, diffusion-weighted imaging (DWI), dynamic susceptibility contrast (DSC), and MR spectroscopy (MRS) and clinical data were retrospectively reviewed. Clinical and MR imaging features were analyzed as possible prognostic factors of high-grade transformation, and multivariate analysis of TTP was performed using Cox proportional modeling.Results: GemA showed more frequent high-grade features than non-GemA, including diffusion restriction (P < .001), increased choline/creatine (P = .02), and increased choline/NAA ratio (P = .015). Patients with GemA had a significantly shorter median TTP (53.1 vs 68 months; P < .001). A gemistocytic histopathology (hazard ratio = 3.42; P = .015) and low ADC (hazard ratio = 3.61; P = .001) were independently associated with a shorter TTP.Conclusions: GemA can present with MR imaging findings mimicking high-grade glioma at initial diagnosis and transforms to high-grade disease earlier than non-GemA. Low ADC on DWI might be useful in stratifying the risk of progression in patients with grade II astrocytoma.Key Points: • Gemistocytic grade II astrocytoma (GemA) showed more frequent high-grade features than non-GemA. • Patients with GemA had a significantly shorter median TTP than non-GemA. • Gemistocytic histopathology and low ADC were independently associated with shorter TTP. [ABSTRACT FROM AUTHOR]- Published
- 2017
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