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Gyriform infiltration as imaging biomarker for molecular glioblastomas

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Abstract

Background

Molecular glioblastomas (i.e. without the histological but with the molecular characteristics of IDH-wild-type glioblastoma) frequently lack contrast enhancement, which can wrongly lead to suspect a lower-grade glioma. Herein, we aimed to assess the diagnostic value of gyriform infiltration as an imaging marker for molecular glioblastomas.

Methods

Two independent investigators reviewed the MRI scans from patients with newly diagnosed gliomas for the presence of a gyriform infiltration defined as an elective cortical hypersignal on MRI FLAIR sequence. Diagnostic test performance of this sign for the diagnosis of molecular glioblastoma were calculated.

Results

A total of 426 patients were included, corresponding to 31 molecular glioblastoma, 294 IDH-wild-type glioblastoma, 50 IDH-mutant astrocytoma, and 51 IDH-mutant 1p19q-codeleted oligodendroglioma. A gyriform infiltration was observed in 16/31 (52%) molecular glioblastoma, 40/294 (14%) IDH-wild-type glioblastoma, and none of the IDH-mutant glioma. All the 56 gyriform-infiltration-positive tumors were IDH-wild-type and all but two had a TERT promoter mutation. The inter-rater agreement was good (κ = 0.69, p < 0.001). The sensitivity, specificity, positive predictive value and negative predictive value of the presence of a gyriform infiltration for the diagnosis of molecular glioblastoma were 52%, 90%, 29%, 96%, respectively. The median overall survival was better for gyriform-infiltration-negative patients compared to gyriform-infiltration-positive patients in the whole series and in patients with non-enhancing lesions (n = 95) (25.6 vs 16.9 months, p = 0.005 and 20.2 months vs not reached, p < 0.001).

Conclusion

Gyriform infiltration is a specific imaging marker of molecular glioblastomas that can help distinguishing these tumors from IDH-mutant lower-grade gliomas.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank Helene Boyer (from DRCI department of HCL) for the review of this manuscript (English writing).

Funding

This analysis was not funded.

Author information

Authors and Affiliations

  1. Department of Neuro-Oncology, Hôpital Neurologique, Hospices Civils de Lyon, Lyon, France

    Emmanuel Mesny, Jérôme Honnorat & François Ducray

  2. Department of Radiotherapy, Centre Hospitalier Universitaire Lyon Sud, Pierre-Bénite, France

    Emmanuel Mesny & Anne d’Hombres

  3. Institut de Pathologie de L’Est, Hospices Civils de Lyon, Lyon, France

    Marc Barritault, Delphine Poncet & David Meyronet

  4. Department of Cancer Cell Plasticity, Cancer Research Centre of Lyon, INSERM U1052, CNRS UMR5286, Lyon, France

    Marc Barritault, David Meyronet & François Ducray

  5. Universités de Lyon, Université Claude Bernard, Lyon 1, Lyon, France

    Marc Barritault, Delphine Poncet, Emmanuel Jouanneau, Jérôme Honnorat, David Meyronet & François Ducray

  6. Service of Neurology, Department of Neuroscience, Hospital Universitari Germans Trias I Pujol, Barcelona, Spain

    Cristina Izquierdo

  7. Department of Neurosurgery, Hospices Civils de Lyon, Lyon, France

    Jacques Guyotat & Emmanuel Jouanneau

  8. Department of Neuro-Radiology, Hôpital Neurologique, Hospices Civils de Lyon, Lyon, France

    Roxana Ameli

  9. Synaptopathies and Autoantibodies, SynatAc) Team, Institut NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Lyon, France

    Jérôme Honnorat

  10. Signaling, Metabolism and Tumor Progression, Cancer Research Centre of Lyon, INSERM U1052, CNRS UMR 5286, Lyon, France

    Emmanuel Jouanneau

  11. Service d’oncologie Radiothérapie CHU Lyon Sud, Hospices Civil de Lyon, 165 Chem. du Grand Revoyet, 69310, Pierre-Bénite, France

    Emmanuel Mesny

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Contributions

The corresponding author certifies that all authors have made substantial contributions to all of the following: EM, FD: conception and design of the study, analysis and interpretation of data, acquisition of data, MRI analysis, EM: statistical analysis, All authors: drafting the article or revising it critically for important intellectual content, All authors: Final approval of the version to be submitted.

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Correspondence to Emmanuel Mesny.

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Mesny, E., Barritault, M., Izquierdo, C. et al. Gyriform infiltration as imaging biomarker for molecular glioblastomas. J Neurooncol 157, 511–521 (2022). https://doi.org/10.1007/s11060-022-03995-9

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  • DOI: https://doi.org/10.1007/s11060-022-03995-9

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