Risk estimation in non-enhancing glioma

• Verfasst von: Dao Trong, Huy Philip [VerfasserIn]
• Verfasst von: Kilian, Samuel [VerfasserIn]
• Verfasst von: Jesser, Jessica [VerfasserIn]
• Verfasst von: Reuss, David [VerfasserIn]
• Verfasst von: Aras, Fuat Kaan [VerfasserIn]
• Verfasst von: Deimling, Andreas von [VerfasserIn]
• Verfasst von: Herold-Mende, Christel [VerfasserIn]
• Verfasst von: Unterberg, Andreas [VerfasserIn]
• Verfasst von: Jungk, Christine [VerfasserIn]
• Titel: Risk estimation in non-enhancing glioma
• Titelzusatz: introducing a clinical sore
• Verf.angabe: Philip Dao Trong, Samuel Kilian, Jessica Jesser, David Reuss, Fuat Kaan Aras, Andreas Von Deimling, Christel Herold-Mende, Andreas Unterberg and Christine Jungk
• E-Jahr: 2023
• Jahr: 27 April 2023
• Umfang: 14 S.
• Fussnoten: Gesehen am 12.06.2023
• Titel Quelle: Enthalten in: Cancers
• Ort Quelle: Basel : MDPI, 2009
• Jahr Quelle: 2023
• Band/Heft Quelle: 15(2023), 9 vom: Apr., Artikel-ID 2503, Seite 1-14
• ISSN Quelle: 2072-6694
• DOI: doi:10.3390/cancers15092503
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: CDKN2A/B
• Sach-SW: IDH mutation
• Sach-SW: lower-grade glioma
• Sach-SW: malignant glioma
• Sach-SW: molecular classification
• Sach-SW: non-enhancing glioma
• Sach-SW: prognostic score
• Sach-SW: risk estimation
• K10plus-PPN: 1848796668

Abstract

The preoperative grading of non-enhancing glioma (NEG) remains challenging. Herein, we analyzed clinical and magnetic resonance imaging (MRI) features to predict malignancy in NEG according to the 2021 WHO classification and developed a clinical score, facilitating risk estimation. A discovery cohort (2012-2017, n = 72) was analyzed for MRI and clinical features (T2/FLAIR mismatch sign, subventricular zone (SVZ) involvement, tumor volume, growth rate, age, Pignatti score, and symptoms). Despite a “low-grade” appearance on MRI, 81% of patients were classified as WHO grade 3 or 4. Malignancy was then stratified by: (1) WHO grade (WHO grade 2 vs. WHO grade 3 + 4) and (2) molecular criteria (IDHmut WHO grade 2 + 3 vs. IDHwt glioblastoma + IDHmut astrocytoma WHO grade 4). Age, Pignatti score, SVZ involvement, and T2/FLAIR mismatch sign predicted malignancy only when considering molecular criteria, including IDH mutation and CDKN2A/B deletion status. A multivariate regression confirmed age and T2/FLAIR mismatch sign as independent predictors (p = 0.0009; p = 0.011). A “risk estimation in non-enhancing glioma” (RENEG) score was derived and tested in a validation cohort (2018-2019, n = 40), yielding a higher predictive value than the Pignatti score or the T2/FLAIR mismatch sign (AUC of receiver operating characteristics = 0.89). The prevalence of malignant glioma was high in this series of NEGs, supporting an upfront diagnosis and treatment approach. A clinical score with robust test performance was developed that identifies patients at risk for malignancy.