Histopathological grades as prognostic factors of H3 K27-altered diffuse midline glioma and their prediction using multiparametric MR imaging.
Background: H3K27-altered diffuse midline gliomas (H3K27-altered DMGs) are classified as WHO grade 4 tumors despite their histopathological characteristics. However, histopathological grades are known to have an important effect on prognosis. This study aims to investigate the prognostic impact of h...
| Publicado en: | Neuroradiology Vol. 67; no. 6; pp. 1605 - 1615 |
|---|---|
| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jun2025
|
| 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=187382631&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 187382631 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00283940 NYZ jtl: Neuroradiology issn: 00283940 maglogo: N pubinfo: dt: Jun2025 vid: 67 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 187382631 185721176 187382631 187382631 10.1007/s00234-025-03660-8 187382631 ppf: 1605 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Histopathological grades as prognostic factors of H3 K27-altered diffuse midline glioma and their prediction using multiparametric MR imaging. aug: au: Deng, Yujiao Su, Xiaorui Yang, Yuan Gong, Jing Chen, Ni Yue, Qiang affil: https://ror.org/007mrxy13 Department of Radiology, West China Hospital of Sichuan University, Chengdu, China sug: subj: Magnetic Resonance Imaging Histology Glioma Pathology Glioma Prognosis Glioma Risk Factors Risk Assessment Histones Neoplasm Grading Human Retrospective Design Pathologists Kaplan-Meier Estimator Linear Regression Overall Survival Cerebrovascular Circulation Descriptive Statistics Models, Statistical Funding Source ab: Background: H3K27-altered diffuse midline gliomas (H3K27-altered DMGs) are classified as WHO grade 4 tumors despite their histopathological characteristics. However, histopathological grades are known to have an important effect on prognosis. This study aims to investigate the prognostic impact of histopathological grades on H3K27-altered DMGs and to predict the grades using multiparametric MRI. Methods: We conducted a retrospective study on H3K27-altered DMG patients diagnosed between December 2016 and February 2023. Tumors were classified as histologically lower- or high-grade DMGs by experienced pathologists. The influence of histopathological grades on prognosis was analyzed by Kaplan-Meier curve and Cox regression. Propensity score matching minimized baseline bias. Clinical and multimodal MRI variables were analyzed through age-stratified subgroup analysis. Logistic regression model was constructed for grade prediction and evaluated using the C-index and F1 score. Results: 90 (53 lower-grade, 37 high-grade) had survival data and 44 (26 lower-grade, 18 high-grade) had complete multiparametric MRI data. Lower-grade patients exhibited significantly longer median overall survival than high-grade (10.5 months vs. 4 months, p < 0.05). Histopathological grade was confirmed as an independent prognostic factor. Qualitative MR imaging features revealed that high-grade DMGs in juveniles showed significantly larger enhancement quality and edema proportion (p < 0.05). Quantitative perfusion parameters like relative cerebral blood flow (rCBF) and relative cerebral blood volume (rCBV) differed significantly between high- and lower-grade groups in both juveniles and adults (p < 0.05). rCBF_99th, enhancement quality, and edema proportion, selected from variables with intergroup differences, formed a nomogram model with a C-index of 0.8596, AUC of 0.885 (0.833 validation), and F1 score of 0.8648. Conclusions: Histological grades could not be ignored when assessing the prognosis of H3K27-altered DMGs. Multimodal MR imaging signatures may play an important role in the prediction of histological grades and thus contribute to a layered risk management of DMGs. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|