Characterization of longitudinal transformation of T2-hyperintensity in oligodendroglioma
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RESEARCH ARTICLE
Open Access
Characterization of longitudinal transformation of T2-hyperintensity in oligodendroglioma Dieter H. Heiland1,2,3* , Robin Ohle1,2,3, Debora Cipriani1,2,3, Pamela Franco1,2,3, Daniel Delev4, Simon P. Behriger1,2,3, Elias Kellner5, Gergana Petrova1,2,3, Nicolas Neidert1,2,3, Irina Mader6, Mateo Fariña Nuñez1,2,3, Horst Urbach3,7, Roman Sankowski3,8,9, Jürgen Beck2,3 and Oliver Schnell1,2,3
Abstract Background: Oligodendroglioma (ODG) are CNS resistant tumors characterized by their unique molecular signature, namely a combined deletion of 1p and 19q simultaneously to an IDH1/2 mutation. These tumors have a more favorable clinical outcome compared to other gliomas and a long-time survival that ranges between 10 and 20 years. However, during the course of the disease, multiple recurrences occur and the optimal treatment at each stage of the disease remains unclear. Here we report a retrospective longitudinal observation study of 836 MRI examinations in 44 ODG patients. Methods: We quantified the volume of T2-hyperintensity to compute growth behavior in dependence of different treatment modalities, using various computational models. Results: The identified growth pattern revealed dynamic changes, which were found to be patient-specific an did not correlate with clinical parameter or therapeutic interventions. Further, we showed that, surgical resection is beneficial for overall survival regardless the WHO grad or timepoint of surgery. To improve overall survival, an extent of resection above 50% is required. Multiple resections do not generally improve overall survival, except a greater extent of resection than in previous surgeries was achieved. Conclusions: Our data aids to improve the interpretation of MRI images in clinical practice. Keywords: Oligodendroglioma, MR-imaging, Segmentation
Background Oligodendroglioma is the third most common type of diffusely infiltrative glioma, with an annual incidence of about 0.6 cases per 100,000 people [1] and accounts for 4–15% of all gliomas [2]. In the revised version of the WHO classification of tumors of the central nervous system of 2016, both histological and molecular parameters * Correspondence: [email protected] 1 Translational NeuroOncology Research Group, Medical Center, University of Freiburg, Freiburg, Germany 2 Department of Neurosurgery, Medical Center, University of Freiburg, Breisacher Straße 64, 79106 Freiburg, Germany Full list of author information is available at the end of the article
were included for the first time to define several glioma entities [3]. Since then, oligodendrogliomas are now characterized by a distinct molecular genotype namely the 1p19q co-deletion along with the simultaneous presence of an IDH1/2 mutation and are further graded according to their histopathological degree of malignancy [3]. Although oligodendrogliomas show highly variable clinical courses with overall survival rates ranging between 6 months and more than 20 years [4], the prognosis is relatively favorable with
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