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Prediction of anaplastic transformation in low-grade oligodendrogliomas based on magnetic resonance spectroscopy and 1p/19q codeletion status

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Abstract

The aim of this study was to assess whether combining multimodal magnetic resonance imaging (MRI) with the determination of the 1p/19q codeletion status could improve the ability to predict anaplastic transformation in low-grade oligodendrogliomas. Twenty patients with grade II oligodendrogliomas were followed-up using multimodal MR [proton MR spectroscopy (MRS), perfusion, and conventional MR imaging]. All patients diagnoses were histologically proven, and 1p/19q codeletion status was analyzed for all patients. Median follow-up was 30.5 ± 11.4 months. Anaplastic transformation was observed in six patients. The only MRI feature that was associated with anaplastic transformation was an elevation of the choline/creatine ratio >2.4 which was observed in 4 out of 6 patients with anaplastic transformation versus 1 out of 14 patients without anaplastic transformation. In patients without 1p/19q codeletion, an elevation of the choline/creatine ratio >2.4 was associated with the occurrence of anaplastic transformation in all cases (4 out of 4 patients), with a mean time of 12 months. In contrast, in patients with a 1p/19q codeletion, no anaplastic transformation was observed in the patient who had an elevation of >2.4 of the choline/creatine ratio and two patients demonstrated an anaplastic transformation without any elevation of this ratio.Prospective validation in a larger series is needed, yet the present study suggests that combining data from in vivo proton MRS and genetic analysis could be a promising strategy to predict time to anaplastic transformation at the individual level in patients with low-grade oligodendrogliomas and may help deciding when chemotherapy and/or radiotherapy should be initiated in these tumors.

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Acknowledgments

Dr. Stephane Sanchez (Biostatistics and Public Health Department of the Hospices Civils de Lyon) for his expertise and help on statistics.

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Authors and Affiliations

  1. Department of Neurosurgery, Hôpital Pierre Wertheimer, Hospices civils de Lyon, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France

    Pierre Bourdillon & Jacques Guyotat

  2. Department of Radiology, Centre Hospitalier Lyon Sud, Hospices civils de Lyon, Université Claude Bernard Lyon 1, Université de Lyon, 130 Rue Jules Guesde, Pierre-Bénite, 69310, Lyon, France

    Chadi Hlaihel & François Cotton

  3. Department of neurology, Hôpital d’instruction des armées Desgenettes, Lyon, France

    Laurent Guillotton

  4. Department of neuro-oncology, Hôpital Pierre Wertheimer, Hospices civils de Lyon, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France

    Jérôme Honnorat & François Ducray

  5. CREATIS-LRMN, CNRS UMR 5220, INSERM U630, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France

    François Cotton

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  1. Pierre Bourdillon
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Bourdillon, P., Hlaihel, C., Guyotat, J. et al. Prediction of anaplastic transformation in low-grade oligodendrogliomas based on magnetic resonance spectroscopy and 1p/19q codeletion status. J Neurooncol 122, 529–537 (2015). https://doi.org/10.1007/s11060-015-1737-x

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