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01-07-2017 | Magnetic Resonance

Prognostic relevance of gemistocytic grade II astrocytoma: gemistocytic component and MR imaging features compared to non-gemistocytic grade II astrocytoma

Authors: Young Jin Heo, Ji Eun Park, Ho Sung Kim, Ji Ye Lee, Soo Jeong Nam, Seung Chai Jung, Choong Gon Choi, Sang Joon Kim

Published in: European Radiology | Issue 7/2017

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.

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Title: Prognostic relevance of gemistocytic grade II astrocytoma: gemistocytic component and MR imaging features compared to non-gemistocytic grade II astrocytoma
Authors: Young Jin Heo
Ji Eun Park
Ho Sung Kim
Ji Ye Lee
Soo Jeong Nam
Seung Chai Jung
Choong Gon Choi
Sang Joon Kim
Publication date: 01-07-2017
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 7/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4649-z

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Prognostic relevance of gemistocytic grade II astrocytoma: gemistocytic component and MR imaging features compared to non-gemistocytic grade II astrocytoma

Abstract

Objectives

Materials and methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Key Points

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