cIMPACT-NOW update 3: recommended diagnostic criteria for “Diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma, WHO grade IV”

Brat, Daniel J.; Aldape, Kenneth; Colman, Howard; Holland, Eric C.; Louis, David N.; Jenkins, Robert B.; Kleinschmidt‐DeMasters, Bette K.; Perry, Arie; Reifenberger, Guido; Stupp, Roger; Deimling, Andreas von; Weller, Michael

doi:10.1007/s00401-018-1913-0

Cited by 660 publications

(585 citation statements)

References 45 publications

(82 reference statements)

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“…Several important biomarkers have been identified to further stratify LGGs, including genetic alterations in CDKN2A/B in astrocytoma with IDH-mutant (11,33); EGFR amplification, chromosome 7 gain and chromosome 10 loss, and TERT promoter mutation in astrocytoma with IDHwild-type (11). Importantly, "the EGFR amplification, or chromosome 7 gain and chromosome 10 loss, or TERT promoter mutation" had been recommended as the diagnostic criteria for "diffuse astrocytic glioma, IDH-wild-type, with molecular features of GBM, WHO grade IV" by the Consortium to Inform Molecular and Practical Approaches to Central Nervous System Tumor Taxonomy (34). Thus, further stratification of LGGs with definite IDH and 1p/19q status is urgently needed.…”

Section: Discussionmentioning

confidence: 99%

RNA processing genes characterize RNA splicing and further stratify lower-grade glioma

Chai¹,

Li²,

Zhang³

et al. 2019

JCI Insight

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Section: Discussionmentioning

confidence: 99%

RNA processing genes characterize RNA splicing and further stratify lower-grade glioma

Chai¹,

Li²,

Zhang³

et al. 2019

JCI Insight

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“…Although in the present study gliomas were classified accordingly to the currently used 2016 WHO classification of the brain tumors, it is desirable in the future to molecularly characterize diffuse astrocytic gliomas, IDH-wildtype, in order to recognize those that can indeed be classified as diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma, WHO grade IV [31,32]. Additional information deriving from next generation sequencing analysis would help stratify postoperative seizure outcome in DLGGs, using markers with known pathophysiological roles in epilepsy such as glutamate metabolism/clearance [5].…”

Section: Limitation and Future Directionsmentioning

confidence: 99%

Predictors of Postoperative Seizure Outcome in Low Grade Glioma: From Volumetric Analysis to Molecular Stratification

Ius

Pauletto

Tomasino

et al. 2020

Cancers

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The importance of the extent of resection (EOR) has been widely demonstrated as the main predictor for survival, nevertheless its effect on tumor related epilepsy is less investigated. A total of 155 patients were enrolled after a first-line surgery for supratentorial Diffuse Low Grade Gliomas (DLGGs). Postoperative seizure outcome was analyzed stratifying the results by tumor volumetric data and molecular markers according to 2016 WHO classification. Receiver operating characteristic (ROC) curves were computed to asses EOR, residual tumor volume, and ∆T2T1 MRI index (expressing the tumor growing pattern) corresponding to optimal seizure outcome. A total of 70.97% of patients were seizure-free 18 months after surgery. Better seizure outcome was observed in IDH1/2 mutated and 1p/19q codeleted subgroup. At multivariate analysis, age (p = 0.014), EOR (p = 0.030), ∆T2T1 MRI index (p = 0.016) resulted as independent predictors of postoperative seizure control. Optimal parameters to improve postoperative seizure outcome were EOR ≥ 85%, ∆T2T1 MRI index ≤ 18 cm 3 , residual tumor volume ≤ 15 cm 3 . This study confirms the role of EOR and tumor growing pattern on postoperative seizure outcome independently from the molecular class. Higher ∆T2T1 MRI index, representing the infiltrative component of the tumor, is associated with worse seizure outcome and strengthens the evidence of common pathogenic mechanisms underlying tumor growth and postoperative seizure outcome.to manifest with focal and focal-to-bilateral tonic-clonic seizures, and more than 50% of cases show pharmaco-resistance, which contributes negatively on quality of life [3][4][5]. Recent studies have pointed out that epileptogenesis and tumor growth in DLGG may share common pathogenic mechanisms that can influence each other, thus representing two aspects of the same disease [6]. In this context, several genetic alterations have been identified as risk factors of glioma-related epilepsy. Mutations of the gene encoding the isocitrate-dehydrogenase1 (IDH1) and 2 (IDH2) can be found in about 70%-80% of DLGG [7]. These mutations have been associated with metabolic changes that are potentially epileptogenic, in accordance with the capability of IDH-mutated glioma cells to penetrate and surround the neurons in the gray matter [8,9].Seizure outcome represents an important challenge in the daily management of DLGG patients. In particular, decision-making still varies across surgical centers given the lack of well-established and universally recognized predictors of seizure outcomes.In the last decades, numerous studies, based on the objective evaluation of the extent of resection (EOR) has been published, demonstrating that an extensive surgery leads to increased overall patient survival and decreased malignant progression [10][11][12][13][14].Although EOR has also been shown to be one of the main strongest significant predictor markers for seizure outcome [7,[15][16][17][18], its predictive role has not been completely clarified in complex predictor models for epilep...

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“…Both parameters failed to show a significant association in a linear model with either maximal or mean Ki67 over GTV (p = .992 for rCBV, p = .899 for wavelet-MRP). Results can be found in S1 Table. Discussion Microvascular proliferation (MVP) is a hallmark of GBM and an important parameter in the histopathological analysis of tumor tissue [14][15][16]. This study demonstrates that wavelet reconstructions of DSC PWI are associated with the number of CD31 positive vessels, and that wavelet-MRP might therefore serve as a surrogate for MVP.…”

Section: Neither Maximum Nor Mean Proliferation Correlate With Perfusmentioning

confidence: 69%

The wavelet power spectrum of perfusion weighted MRI correlates with tumor vascularity in biopsy-proven glioblastoma samples

et al. 2020

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BackgroundWavelet transformed reconstructions of dynamic susceptibility contrast (DSC) MR perfusion (wavelet-MRP) are a new and elegant way of visualizing vascularization. Wavelet-MRP maps yield a clear depiction of hypervascular tumor regions, as recently shown. ResultsThere was a strong correlation between wavelet-MRP power spectrum (median = 4.41) and conventional relative cerebral blood volume (median = 5.97 ml/100g) in Spearman's rankorder correlation (κ = .83, p < .05). In a logistic regression model, the wavelet-MRP power spectrum showed a significant correlation to CD31 dichotomized to no or present staining

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cIMPACT-NOW update 3: recommended diagnostic criteria for “Diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma, WHO grade IV”

Cited by 660 publications

References 45 publications

RNA processing genes characterize RNA splicing and further stratify lower-grade glioma

RNA processing genes characterize RNA splicing and further stratify lower-grade glioma

Predictors of Postoperative Seizure Outcome in Low Grade Glioma: From Volumetric Analysis to Molecular Stratification

The wavelet power spectrum of perfusion weighted MRI correlates with tumor vascularity in biopsy-proven glioblastoma samples

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