Introduction

Recent studies have identified that glioblastoma IDH-wildtype consists of different molecular subgroups with distinct prognoses. In order to accurately describe and classify gliomas, the Visually AcceSAble Rembrandt Images (VASARI) system was developed. The goal of this study was to evaluate the VASARI characteristics in molecular subgroups of IDH-wildtype glioblastoma.

Methods

A retrospective analysis of glioblastoma IDH- wildtype with comprehensive next-generation sequencing and pre-operative and post-operative MRI was performed. VASARI characteristics and 205 genes were evaluated. Multiple comparison adjustment by the Bejamin-Hochberg false discovery rate (BH-FDR) was performed. A 1:3 propensity score match (PSM) with a Caliper of 0.2 was done.

Results

178 patients with GBM IDH-WT met the inclusion criteria. 4q12 amplified patients (n = 20) were associated with cyst presence (30% vs. 12%, p = 0.042), decreased hemorrhage (35% vs. 62%, p = 0.028), and non-restricting/mixed (35%/60%) rather than restricting diffusion pattern (5%), meanwhile, 4q12 non-amplified patients had mostly restricting (47.4%) rather than a non-restricting/mixed diffusion pattern (28.4%/23.4%). This remained statistically significant after BH-FDR adjustment (p = 0.002). PSM by 4q12 amplification showed that diffusion characteristics continued to be significantly different. Among RB1-mutant patients, 96% had well-defined enhancing margins vs. 70.6% of RB1-WT (p = 0.018), however, this was not significant after BH-FDR or PSM.

Conclusions

Patients with glioblastoma IDH-wildtype harboring 4q12 amplification rarely have restricting DWI patterns compared to their wildtype counterparts, in which this DWI pattern is present in ~ 50% of patients. This suggests that some phenotypic imaging characteristics can be identified among molecular subtypes of IDH-wildtype glioblastoma.

中文翻译：

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4q12 扩增和 RB1 突变胶质母细胞瘤 IDH 野生型的影像预测因子

介绍

最近的研究发现，IDH 野生型胶质母细胞瘤由具有不同预后的不同分子亚组组成。为了准确地描述和分类神经胶质瘤，开发了视觉可访问的伦勃朗图像（VASARI）系统。本研究的目的是评估 IDH 野生型胶质母细胞瘤分子亚组的 VASARI 特征。

方法

通过全面的下一代测序以及术前和术后 MRI 对胶质母细胞瘤 IDH 野生型进行了回顾性分析。评估了 VASARI 特征和 205 个基因。通过 Bejamin-Hochberg 错误发现率 (BH-FDR) 进行多重比较调整。完成了卡尺为 0.2 的 1:3 倾向得分匹配 (PSM)。

结果

178 名 GBM IDH-WT 患者符合纳入标准。 4q12 扩增患者 ( n  = 20) 与囊肿存在相关 (30% vs. 12%, p  = 0.042)、出血减少 (35% vs. 62%, p  = 0.028) 和非限制性/混合性 (35%) /60%）而不是限制性扩散模式（5%），同时，4q12非扩增患者大多具有限制性（47.4%）而不是非限制性/混合扩散模式（28.4%/23.4%）。经过 BH-FDR 调整后，这一点仍然具有统计学意义（p  = 0.002）。 4q12 扩增的 PSM 显示扩散特性持续显着不同。在RB1突变患者中，96% 的患者具有明确的增强边缘，而RB1突变患者的这一比例为 70.6% ( p  = 0.018)，但是，在 BH-FDR 或 PSM 后，这一点并不显着。

结论

与野生型患者相比，携带 4q12 扩增的 IDH 野生型胶质母细胞瘤患者很少出现限制性 DWI 模式，约 50% 的患者存在这种 DWI 模式。这表明可以在 IDH 野生型胶质母细胞瘤的分子亚型中鉴定出一些表型成像特征。