Prognostic relevance of gemistocytic grade II astrocytoma: gemistocytic component and MR imaging features compared to non-gemistocytic grade II astrocytoma.
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...
| Publicado en: | European Radiology Vol. 27; no. 7; pp. 3022 - 3033 |
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| Autores principales: | , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Jul2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=123476746&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 123476746 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Jul2017 vid: 27 iid: 7 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 123476746 123476746 144191480 NLM27858213 123476746 10.1007/s00330-016-4649-z NLM27858213 123476746 ppf: 3022 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Prognostic relevance of gemistocytic grade II astrocytoma: gemistocytic component and MR imaging features compared to non-gemistocytic grade II astrocytoma. aug: au: Heo, Young Park, Ji Kim, Ho Lee, Ji Nam, Soo Jung, Seung Choi, Choong Kim, Sang Heo, Young Jin Park, Ji Eun Kim, Ho Sung Lee, Ji Ye Nam, Soo Jeong Jung, Seung Chai Choi, Choong Gon Kim, Sang Joon affil: Department of Radiology , Inje University, Busan Paik Hospital , Busan Korea sug: subj: Glioma Pathology Magnetic Resonance Imaging Methods Brain Neoplasms Pathology Neoplasm Grading Methods Magnetic Resonance Spectroscopy Methods Male Adult Female Retrospective Design Disease Progression Human Aged Prognosis Time Factors Prospective Studies Middle Age Validation Studies Comparative Studies Evaluation Research Multicenter Studies Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Male Female ab: 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. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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