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The diagnostic value of contrast enhancement on MRI in diffuse and anaplastic gliomas

  • Original Article - Tumor - Glioma
  • Published:
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Abstract

Purpose

We evaluated differentiations in gadolinium contrast enhancement (CE) between low-grade WHO °II and high-grade WHO °III gliomas in conventional MRI, which have been repeatedly questioned.

Methods

Ninety-nine patients, who underwent first resection of WHO°II and °III gliomas, were retrospectively retrieved from a prospective database. The quantitative metric volume of Gd-CE in T1-weighted pre-operative MRI was measured using volumetric segmentation.

Results

The OR to detect CE in anaplastic gliomas was seven times higher than that in diffuse gliomas (CI95% 2.8–17.2, p<0.0001). No CE was seen in 50% (8/16) of focal anaplastic and in 28% (10/36) of entirely anaplastic gliomas. CE was present in 21% (10/47) of diffuse gliomas. Anaplasia correlated with a larger CE volume (r=0.49, p<0.0001) and provided additional 4 cm3 of CE volume compared to entirely diffuse tumors. The OR to have CE was 3.6 times for IDH1 wild-type tumors (CI95% 1.3–10.2, p=0.05) and 4.8 for tumors with ATRX expression (CI95% 1.3–17.2, p=0.05). In all sub-groups, at least a quarter of cases showed no CE at all and there were cases with present CE.

Conclusion

CE is associated with higher odds of unfavorable prognostic features like anaplasia, wild-type IDH1 and retained ATRX. There was no CE in one-fourth of anaplastic gliomas and half of gliomas with focal anaplasia.

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Availability of data and material

The raw data was generated in the authors’ institution. The data that support the findings of this study are available on reasonable request from the corresponding author. The data are not publicly available due their containing information that could compromise the privacy of research participants.

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Authors and Affiliations

  1. Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Aleksandrs Krigers, Matthias Demetz, Claudius Thomé & Christian F. Freyschlag

  2. Department of Neuroradiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Astrid E. Grams

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Contributions

Conceptualization, A.K. and C.F.F.; methodology, A.K. and C.F.F.; software, M.D. and A.K.; validation, A.K. and C.F.F..; formal analysis, A.K.; investigation, A.K. and M.D.; resources, C.F.F., C.T. and A.G.; data curation, A.K. and M.D.; writing—original draft preparation, A.K. and M.D.; writing—review and editing, C.F.F, C.T and A.G.; supervision, C.F.F and C.T.; project administration, A.K. and C.F.F. All the authors read and approved the final version of the manuscript.

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Correspondence to Aleksandrs Krigers.

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Conflict of interest

The authors declare no competing interests.

Ethics approval

All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Bioethics Committee of the Medical University of Innsbruck (AN5220 329/4.4, EK Nr. 1333/2021).

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Informed consent was obtained from all individual participants included in the study (AN5220 329/4.4).

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No individual data is showed separately in the manuscript. All data are used only after anonymized statistical processing and are described with pool results.

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Krigers, A., Demetz, M., Grams, A.E. et al. The diagnostic value of contrast enhancement on MRI in diffuse and anaplastic gliomas. Acta Neurochir 164, 2035–2040 (2022). https://doi.org/10.1007/s00701-021-05103-8

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  • DOI: https://doi.org/10.1007/s00701-021-05103-8

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