Vilde Elisabeth Mikkelsen1, Anne Line Stensjøen2, Erik Magnus Berntsen2, Ivar Skjåk Nordrum3, Øyvind Salvesen4, Ole Solheim5, Sverre Helge Torp3. 1. Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway. Electronic address: vildeem@stud.ntnu.no. 2. Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Department of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway. 3. Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Department of Pathology, St. Olavs University Hospital, Trondheim, Norway. 4. Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway. 5. Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; National Advisory Unit for Ultrasound and Image-Guided Therapy, St. Olavs University Hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
Abstract
BACKGROUND: Rapid growth is a well-known property of glioblastoma (GBM); however, growth rates vary among patients. Mechanisms behind such variation have not been widely studied in human patients. We sought to investigate relationships between histopathologic features and tumor growth estimated from pretreatment magnetic resonance imaging scans. METHODS: In 106 patients with GBM, 2 preoperative T1-weighted magnetic resonance imaging scans obtained at least 14 days apart were segmented to assess tumor growth. A fitted Gompertzian growth curve based on the segmented volumes divided the tumors into 2 groups: faster and slower growth than expected based on the initial tumor volume. Histopathologic features were investigated for associations with these groups, using univariable and multivariable logistic regression analyses. RESULTS: The presence of high cellular density and thromboses was significantly associated with radiologic growth in the multivariable analysis (P = 0.018 and 0.019, respectively), with respective odds ratios of 3.0 (95% confidence interval, 1.2-7.4) and 4.3 (95% confidence interval, 1.3-14.5) for faster growing tumors. CONCLUSIONS: Our findings show that high cellular density and thromboses are significant independent predictors of faster growth in human GBM. This finding underlines the importance of hypercellularity as a criterion in glioma grading. Furthermore, our findings are concordant with hypotheses suggesting hypoxia triggered by thromboses to be relevant for growth of GBM.
BACKGROUND: Rapid growth is a well-known property of glioblastoma (GBM); however, growth rates vary among patients. Mechanisms behind such variation have not been widely studied in humanpatients. We sought to investigate relationships between histopathologic features and tumor growth estimated from pretreatment magnetic resonance imaging scans. METHODS: In 106 patients with GBM, 2 preoperative T1-weighted magnetic resonance imaging scans obtained at least 14 days apart were segmented to assess tumor growth. A fitted Gompertzian growth curve based on the segmented volumes divided the tumors into 2 groups: faster and slower growth than expected based on the initial tumor volume. Histopathologic features were investigated for associations with these groups, using univariable and multivariable logistic regression analyses. RESULTS: The presence of high cellular density and thromboses was significantly associated with radiologic growth in the multivariable analysis (P = 0.018 and 0.019, respectively), with respective odds ratios of 3.0 (95% confidence interval, 1.2-7.4) and 4.3 (95% confidence interval, 1.3-14.5) for faster growing tumors. CONCLUSIONS: Our findings show that high cellular density and thromboses are significant independent predictors of faster growth in human GBM. This finding underlines the importance of hypercellularity as a criterion in glioma grading. Furthermore, our findings are concordant with hypotheses suggesting hypoxia triggered by thromboses to be relevant for growth of GBM.
Authors: Vilde Elisabeth Mikkelsen; Anne Line Stensjøen; Unn Sophie Granli; Erik Magnus Berntsen; Øyvind Salvesen; Ole Solheim; Sverre Helge Torp Journal: BMC Cancer Date: 2018-09-03 Impact factor: 4.430