The T1/T2 Ratio is Associated With Resectability in Patients With Isocitrate Dehydrogenase-Mutant Astrocytomas Central Nervous System World Health Organization Grades 2 and 3.

IF 3.9 2区医学 Q1 CLINICAL NEUROLOGY

Neurosurgery Pub Date : 2025-02-01 Epub Date: 2024-06-26 DOI:10.1227/neu.0000000000003069

Jonathan Weller, Eddie de Dios, Sophie Katzendobler, Alba Corell, Anna Dénes, Michael Schmutzer-Sondergeld, Niloufar Javanmardi, Niklas Thon, Joerg-Christian Tonn, Asgeir S Jakola

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引用次数: 0

Abstract

Background and objectives: Isocitrate dehydrogenase (IDH)-mutant astrocytomas central nervous system World Health Organization grade 2 and 3 show heterogeneous appearance on MRI. In the premolecular era, the discrepancy between T1 hypointense and T2 hyperintense tumor volume in absolute values has been proposed as a marker for diffuse tumor growth. We set out to investigate if a ratio of T1 to T2 tumor volume (T1/T2 ratio) is associated with resectability and overall survival (OS) in patients with IDH-mutant astrocytomas.

Methods: Patient data from 2 centers (Sahlgrenska University Hospital, Center A; LMU University Hospital, Center B) were collected retrospectively. Inclusion criteria were as follows: pre and postoperative MRI scans available for volumetric analysis (I), diagnosis of an IDH-mutant astrocytoma between 2003 and 2021 (II), and tumor resection at initial diagnosis (III). Tumor volumes were manually segmented. The T1/T2 ratio was calculated and correlated with extent of resection, residual T2 tumor volume, and OS.

Results: The study comprised 134 patients with 65 patients included from Center A and 69 patients from Center B. The median OS was 134 months and did not differ between the cohorts ( P = .29). Overall, the median T1/T2 ratio was 0.79 (range 0.15-1.0). Tumors displaying a T1/T2 ratio of 0.33 or lower showed significantly larger residual tumor volumes postoperatively (median 17.9 cm 3 vs 4.6 cm 3 , P = .03). The median extent of resection in these patients was 65% vs 90% ( P = .03). The ratio itself did not correlate with OS. In multivariable analyses, larger postoperative tumor volumes were associated with shorter survival times (hazard ratio 1.02, 95% CI 1.01-1.03, P < .01).

Conclusion: The T1/T2 ratio might be a good indicator for diffuse tumor growth on MRI and is associated with resectability in patients with IDH-mutant astrocytoma. This ratio might aid to identify patients in which an oncologically relevant tumor volume reduction cannot be safely achieved.

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T1/T2比值与异柠檬酸脱氢酶突变型中枢神经系统星形细胞瘤患者的可切除性有关

背景和目的：世界卫生组织 2 级和 3 级中枢神经系统异柠檬酸脱氢酶（IDH）突变星形细胞瘤在核磁共振成像上表现出异质性。在前分子时代，T1 低密度和 T2 高密度肿瘤体积绝对值的差异被认为是肿瘤弥漫生长的标志。我们试图研究 T1 与 T2 肿瘤体积之比（T1/T2 比值）是否与 IDH 突变星形细胞瘤患者的可切除性和总生存率（OS）相关：方法：回顾性收集两个中心（Sahlgrenska 大学医院，中心 A；LMU 大学医院，中心 B）的患者数据。纳入标准如下：术前和术后可进行容积分析的磁共振成像扫描（I），2003年至2021年期间诊断为IDH突变星形细胞瘤（II），初次诊断时切除肿瘤（III）。肿瘤体积由人工分割。计算T1/T2比值，并将其与切除范围、残余T2肿瘤体积和OS相关联：中位OS为134个月，两组之间无差异（P = .29）。总体而言，中位 T1/T2 比率为 0.79（范围为 0.15-1.0）。T1/T2 比率为 0.33 或更低的肿瘤术后残留肿瘤体积明显更大（中位 17.9 cm3 vs 4.6 cm3，P = .03）。这些患者的中位切除范围为 65% vs 90%（P = .03）。比值本身与 OS 无关。在多变量分析中，术后肿瘤体积越大，生存时间越短（危险比 1.02，95% CI 1.01-1.03，P < .01）：T1/T2比值可能是MRI上肿瘤弥漫生长的良好指标，与IDH突变星形细胞瘤患者的可切除性相关。该比值可能有助于确定哪些患者无法安全地缩小肿瘤体积。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurosurgery 医学-临床神经学

CiteScore

8.20

自引率

6.20%

发文量

898

审稿时长

2-4 weeks

期刊介绍： Neurosurgery, the official journal of the Congress of Neurological Surgeons, publishes research on clinical and experimental neurosurgery covering the very latest developments in science, technology, and medicine. For professionals aware of the rapid pace of developments in the field, this journal is nothing short of indispensable as the most complete window on the contemporary field of neurosurgery. Neurosurgery is the fastest-growing journal in the field, with a worldwide reputation for reliable coverage delivered with a fresh and dynamic outlook.