THE MRI shows that SVZ is infringing in combination with tumor genomics to judge the LGG prognostics

MRI imaging shows that glioblastoma (GBM) invades the sub-ventricular membrane (subventrication zone, SVZ), a source region of tumor pregenital cells that makes tumors insensitive to chemotherapy and increases tumor invasiveness and migration.
studies have shown that in WHO LEVEL II and WHO III. as astromas, the shorter the distance between the edge of the tumor and SVZ, the faster the tumor grows, and the worse the patient's prognosis.
of tumors has a significant effect on the prognosis of gliomas, as changes in specific gene pathogenes may play an important role in the invasion and spread of GBM in the brain.
, the relationship between tumor genomics and low-level gliomas (LGG) that invade SVZ remains unclear.
Gloria C. Chiang of the Neuroimaging Department at New York Presbytic Hospital studied the correlation between tumor genomics and infringing SVZ and prognosis in LGG patients, published online July 2020 in JImaging Neuro.
Methods The authors reviewed 45 pathologically diagnosed patient imaging data and genetic test results for LGG between February 2006 and June 2018.
all patients were mrI-tested, and two neuroradiologists read MRI images to determine whether the tumor violated SVZ and measure the distance between the tumor and the edge of the lateral chamber membrane (Figure 1).
45 patients, 41 obtained an oscic diffusion coefficient (see diffusion coefficient, ADC) image in MRI axial dispersion weighted sequence imaging.
the tumor volume through software, and then copied the area of interest (volume-of-interest, VOI) to the ADC image to obtain a histogram value of the tumor volume.
analyzes the 5th percentile, 10th percentile, 25th percentile, median, and average of the ADC graph, and compares it with the normal whiteness of the side.
Figure 1. MRI-FLAIR sequence imaging evaluates SVZ affection.
yellow markers depict violations of the frontal lobe (A), the top lobe (B), the temporal lobe (C), and the pillow lobe (D) SVZ, respectively.
study found that the average age of 45 patients was 48±14 years old, 10 cases (22%) had a complete surgical excision of tumors, and the follow-up time after surgery was 0.3-12.6 years, with an average of 2.3±3.2 years.
24 patients (53%) had tumor progression after surgery, with a medium progression time of 1 year.
5 patients (11%) died after surgery, with a mid-life time of 1.7 years.
patients with 1-6 tumor gene mutations, a medium of 3±1, the most common IDH1 mutation and TP53 mutation;
44 patients, 10 (24%) had a 1p19q deficiency.
these tumor mutations were not related to the violation of SVZ (p>0.05).
cell cycle protein dependent kinase inhibitor 2A/B (cyclin-dependent kinase inhibitor 2A/B, CDKN 2A/B) mutation was associated with pillow leaf glioma invading SVZ;
32 cases of cerebral glioma that violated SVZ, the tumor was located in 15 cases in the frontal lobe, 15 cases in the top lobe, 21 cases in the temporal lobe and 2 cases in the pillow lobe.
distance from the edge of the chamber tube film 0-31mm, the median 0± 7.7mm.
glioma aggression SVZ was associated with a higher risk of progression (HR=6.6; p=0.016);
SVZ was associated with a higher risk of death (HR=31;p=0.015).
post-mortem analysis showed that in subgroups receiving chemotherapy (p-0.047) and partial excision (p-0.026), pyeloma aggression against SVZ remained an important predictive factor for tumor progression and patient death.
IDH1/2, homologic phosphatase-stress protein (phosphatase and tensin homolog, PTEN) and epidermal growth factor receptor (epidermal growth factor receptor, EGFR) gene mutations increase the risk of tumor progression, while the absence of 1p19q is independent of tumor progression.
multi-regression model analysis showed that IDH1 (HR=0.34; p=0.04) and PTEN (HR=1.3; p=0.59) mutations were more relevant to tumor progression than EGFR gene mutations.
PTEN, cell cycle protein dependence kinase 4 (cyclin-dependent kinase 4, CDK4), CDKN2A/B gene mutations were highly associated with the risk of death, and 1p19q deficiency and IDH gene mutations were less associated with the risk of death.
conclusion, the authors believe that in addition to IDH1, PTEN, CDK4, CDKN2A/B and EGFR gene mutations are strong factors in predicting the prognostication of LGG patients.
these gene mutations were not associated with tumor invasion SVZ, but CDKN2A/B gene mutations were associated with pillow leaf glioma invasion of SVZ.
SVZ by pyeloma is not common, but it is still an important predictive factor for tumor progression and survival.
ADC value as an indicator of tumor cell structure, not related to the violation of SVZ, and not very relevant to prognostic.
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