Emmanuel Mesny1,2,3, Marc Barritault4,5,6, Cristina Izquierdo7, Delphine Poncet4,6, Anne d'Hombres8, Jacques Guyotat9, Emmanuel Jouanneau6,9,10, Roxana Ameli11, Jérôme Honnorat12,6,13, David Meyronet4,5,6, François Ducray12,5,6. 1. Department of Neuro-Oncology, Hôpital Neurologique, Hospices Civils de Lyon, Lyon, France. emmanuel.mesny@chu-lyon.fr. 2. Department of Radiotherapy, Centre Hospitalier Universitaire Lyon Sud, Pierre-Bénite, France. emmanuel.mesny@chu-lyon.fr. 3. Service d'oncologie Radiothérapie CHU Lyon Sud, Hospices Civil de Lyon, 165 Chem. du Grand Revoyet, 69310, Pierre-Bénite, France. emmanuel.mesny@chu-lyon.fr. 4. Institut de Pathologie de L'Est, Hospices Civils de Lyon, Lyon, France. 5. Department of Cancer Cell Plasticity, Cancer Research Centre of Lyon, INSERM U1052, CNRS UMR5286, Lyon, France. 6. Universités de Lyon, Université Claude Bernard, Lyon 1, Lyon, France. 7. Service of Neurology, Department of Neuroscience, Hospital Universitari Germans Trias I Pujol, Barcelona, Spain. 8. Department of Radiotherapy, Centre Hospitalier Universitaire Lyon Sud, Pierre-Bénite, France. 9. Department of Neurosurgery, Hospices Civils de Lyon, Lyon, France. 10. Signaling, Metabolism and Tumor Progression, Cancer Research Centre of Lyon, INSERM U1052, CNRS UMR 5286, Lyon, France. 11. Department of Neuro-Radiology, Hôpital Neurologique, Hospices Civils de Lyon, Lyon, France. 12. Department of Neuro-Oncology, Hôpital Neurologique, Hospices Civils de Lyon, Lyon, France. 13. Synaptopathies and Autoantibodies, SynatAc) Team, Institut NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Lyon, France.
Abstract
BACKGROUND: Molecular glioblastomas (i.e. without the histological but with the molecular characteristics of IDH-wild-type glioblastoma) frequently lack contrast enhancement, which can wrongly lead to suspect a lower-grade glioma. Herein, we aimed to assess the diagnostic value of gyriform infiltration as an imaging marker for molecular glioblastomas. METHODS: Two independent investigators reviewed the MRI scans from patients with newly diagnosed gliomas for the presence of a gyriform infiltration defined as an elective cortical hypersignal on MRI FLAIR sequence. Diagnostic test performance of this sign for the diagnosis of molecular glioblastoma were calculated. RESULTS: A total of 426 patients were included, corresponding to 31 molecular glioblastoma, 294 IDH-wild-type glioblastoma, 50 IDH-mutant astrocytoma, and 51 IDH-mutant 1p19q-codeleted oligodendroglioma. A gyriform infiltration was observed in 16/31 (52%) molecular glioblastoma, 40/294 (14%) IDH-wild-type glioblastoma, and none of the IDH-mutant glioma. All the 56 gyriform-infiltration-positive tumors were IDH-wild-type and all but two had a TERT promoter mutation. The inter-rater agreement was good (κ = 0.69, p < 0.001). The sensitivity, specificity, positive predictive value and negative predictive value of the presence of a gyriform infiltration for the diagnosis of molecular glioblastoma were 52%, 90%, 29%, 96%, respectively. The median overall survival was better for gyriform-infiltration-negative patients compared to gyriform-infiltration-positive patients in the whole series and in patients with non-enhancing lesions (n = 95) (25.6 vs 16.9 months, p = 0.005 and 20.2 months vs not reached, p < 0.001). CONCLUSION: Gyriform infiltration is a specific imaging marker of molecular glioblastomas that can help distinguishing these tumors from IDH-mutant lower-grade gliomas.
BACKGROUND: Molecular glioblastomas (i.e. without the histological but with the molecular characteristics of IDH-wild-type glioblastoma) frequently lack contrast enhancement, which can wrongly lead to suspect a lower-grade glioma. Herein, we aimed to assess the diagnostic value of gyriform infiltration as an imaging marker for molecular glioblastomas. METHODS: Two independent investigators reviewed the MRI scans from patients with newly diagnosed gliomas for the presence of a gyriform infiltration defined as an elective cortical hypersignal on MRI FLAIR sequence. Diagnostic test performance of this sign for the diagnosis of molecular glioblastoma were calculated. RESULTS: A total of 426 patients were included, corresponding to 31 molecular glioblastoma, 294 IDH-wild-type glioblastoma, 50 IDH-mutant astrocytoma, and 51 IDH-mutant 1p19q-codeleted oligodendroglioma. A gyriform infiltration was observed in 16/31 (52%) molecular glioblastoma, 40/294 (14%) IDH-wild-type glioblastoma, and none of the IDH-mutant glioma. All the 56 gyriform-infiltration-positive tumors were IDH-wild-type and all but two had a TERT promoter mutation. The inter-rater agreement was good (κ = 0.69, p < 0.001). The sensitivity, specificity, positive predictive value and negative predictive value of the presence of a gyriform infiltration for the diagnosis of molecular glioblastoma were 52%, 90%, 29%, 96%, respectively. The median overall survival was better for gyriform-infiltration-negative patients compared to gyriform-infiltration-positive patients in the whole series and in patients with non-enhancing lesions (n = 95) (25.6 vs 16.9 months, p = 0.005 and 20.2 months vs not reached, p < 0.001). CONCLUSION: Gyriform infiltration is a specific imaging marker of molecular glioblastomas that can help distinguishing these tumors from IDH-mutant lower-grade gliomas.
Authors: Sohil H Patel; Laila M Poisson; Daniel J Brat; Yueren Zhou; Lee Cooper; Matija Snuderl; Cheddhi Thomas; Ana M Franceschi; Brent Griffith; Adam E Flanders; John G Golfinos; Andrew S Chi; Rajan Jain Journal: Clin Cancer Res Date: 2017-07-27 Impact factor: 12.531
Authors: David N Louis; Pieter Wesseling; Kenneth Aldape; Daniel J Brat; David Capper; Ian A Cree; Charles Eberhart; Dominique Figarella-Branger; Maryam Fouladi; Gregory N Fuller; Caterina Giannini; Christine Haberler; Cynthia Hawkins; Takashi Komori; Johan M Kros; H K Ng; Brent A Orr; Sung-Hye Park; Werner Paulus; Arie Perry; Torsten Pietsch; Guido Reifenberger; Marc Rosenblum; Brian Rous; Felix Sahm; Chitra Sarkar; David A Solomon; Uri Tabori; Martin J van den Bent; Andreas von Deimling; Michael Weller; Valerie A White; David W Ellison Journal: Brain Pathol Date: 2020-04-19 Impact factor: 6.508
Authors: Damian Stichel; Azadeh Ebrahimi; David Reuss; Daniel Schrimpf; Takahiro Ono; Mitsuaki Shirahata; Guido Reifenberger; Michael Weller; Daniel Hänggi; Wolfgang Wick; Christel Herold-Mende; Manfred Westphal; Sebastian Brandner; Stefan M Pfister; David Capper; Felix Sahm; Andreas von Deimling Journal: Acta Neuropathol Date: 2018-09-05 Impact factor: 17.088
Authors: Changho Choi; Sandeep K Ganji; Ralph J DeBerardinis; Kimmo J Hatanpaa; Dinesh Rakheja; Zoltan Kovacs; Xiao-Li Yang; Tomoyuki Mashimo; Jack M Raisanen; Isaac Marin-Valencia; Juan M Pascual; Christopher J Madden; Bruce E Mickey; Craig R Malloy; Robert M Bachoo; Elizabeth A Maher Journal: Nat Med Date: 2012-01-26 Impact factor: 53.440
Authors: Martinus P G Broen; Marion Smits; Maarten M J Wijnenga; Hendrikus J Dubbink; Monique H M E Anten; Olaf E M G Schijns; Jan Beckervordersandforth; Alida A Postma; Martin J van den Bent Journal: Neuro Oncol Date: 2018-09-03 Impact factor: 13.029
Authors: David N Louis; Arie Perry; Pieter Wesseling; Daniel J Brat; Ian A Cree; Dominique Figarella-Branger; Cynthia Hawkins; H K Ng; Stefan M Pfister; Guido Reifenberger; Riccardo Soffietti; Andreas von Deimling; David W Ellison Journal: Neuro Oncol Date: 2021-08-02 Impact factor: 13.029