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Prognostic relevance of gemistocytic grade II astrocytoma: gemistocytic component and MR imaging features compared to non-gemistocytic grade II astrocytoma.
- Source :
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European radiology [Eur Radiol] 2017 Jul; Vol. 27 (7), pp. 3022-3032. Date of Electronic Publication: 2016 Nov 17. - Publication Year :
- 2017
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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).<br />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.<br />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.<br />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.<br />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.
Details
- Language :
- English
- ISSN :
- 1432-1084
- Volume :
- 27
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- European radiology
- Publication Type :
- Academic Journal
- Accession number :
- 27858213
- Full Text :
- https://doi.org/10.1007/s00330-016-4649-z