CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(04): 752-758
DOI: 10.4103/ajns.AJNS_520_20
Original Article

Can apparent diffusion coefficient predict the grade, genotype, or proliferation index of oligodendrogliomas

Laghari Ali
Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi
,
Khalid Usman
Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi
,
Mubarak Fatima
1   Department of Radiology, Aga Khan University Hospital, Stadium Road, Karachi
,
Alvi Amna
1   Department of Radiology, Aga Khan University Hospital, Stadium Road, Karachi
,
Ali Saeed
2   School of Nursing and Midwifery, The Aga Khan University, Karachi
,
Shaikh Qadeer
Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi
,
Shamim Shahzad
Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi
,
Enam Ather
Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi
› Author Affiliations

Background: Genetic subsets of oligodendrogliomas (OD) have distinct chromosomal and biophysical profiles. Pretherapeutic tumor grade and genotype analysis is a challenging aspect of management, with 1p/19q codeletion status and grade of oligodendroglioma among the most important considerations for clinical decision making. Methodology: Seventy-three patients with histopathological diagnosis of oligodendroglioma were selected, and their preoperative 1.5T magnetic resonance imaging (MRI) scans were reviewed through parameters including diffusion weighted image, susceptibility-weighted imaging, and apparent diffusion coefficient (ADC). These images were correlated with patients' histopathological and chromosomal testing. Tumor border irregularity, homogeneity, contrast enhancement, and other MRI characteristics were also studied. For analysis, descriptive statistics were generated, and normality was evaluated for ADC value, age, and Ki-67 tumor proliferation index. Objectives: The study aimed to determine the correlation of ADC with Ki-67, grade, and 1p/19q co-deletion in oligodendroglioma at a tertiary care hospital within a low-middle income country. Results: Ki-67 tumor proliferation index was high in 33 tumors. It was found to be statistically significant (P = 0.048) with respect to ADC, showing that 1p/19q co-deleted tumors have a difference in their Ki-67 index. Ki-67 also showed a significant relationship (P < 0.05) with grade of OD. However, there was no statistically significant relationship between 1p19q chromosomal co-deletion and ADC. Linear regression was carried out as the data set was continuous. Univariate analysis showed no significant result with all P values above 0.10. Conclusion: Mean ADC is a viable tool to predict Ki-67 and assist prognostic clinical decisions. However, mean ADC alone cannot predict 1p/19q codeletion and tumor grades in OD. Further supplementation with other radiological modalities may provide greater yield and positive results.

Financial support and sponsorship

Nil.




Publication History

Received: 02 December 2020

Accepted: 14 July 2021

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Ostrom QT, Bauchet L, Davis FG, Deltour I, Fisher JL, Langer CE, et al. The epidemiology of glioma in adults: A 'state of the science' review. Neuro Oncol 2014;16:896-913. https://pubmed.ncbi.nlm.nih.gov/24842956/
  • 2 Komori T. The 2016 WHO Classification of Tumours of the Central Nervous System: The Major Points of Revision. Neurol Med Chir (Tokyo) 2017;57:301-11.
  • 3 Jenkins RB, Blair H, Ballman KV, Giannini C, Arusell RM, Law M, et al. A t (1;19)(q10;p10) mediates the combined deletions of 1p and 19q and predicts a better prognosis of patients with oligodendroglioma. Cancer Res 2006;66:9852-61. https://pubmed.ncbi.nlm.nih.gov/22207304/.
  • 4 Ducray F, Idbaih A, de Reyniès A, Bièche I, Thillet J, Mokhtari K, et al. Anaplastic oligodendrogliomas with 1p19q codeletion have a proneural gene expression profile. Mol Cancer 2008;7:41.
  • 5 Ręcławowicz D, Stempniewicz M, Biernat W, Limon J, Słoniewski P. Loss of genetic material within 1p and 19q chromosomal arms in low grade gliomas of central nervous system. Folia Neuropathol 2013;51:26-32.
  • 6 Hoshide R, Jandial R. 2016 World Health Organization Classification of Central Nervous System Tumors: An era of molecular biology. World Neurosurg 2016;94:561-2.
  • 7 Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: A summary. Acta Neuropathol 2016;131:803-20.
  • 8 van den Bent MJ, Looijenga LH, Langenberg K, Dinjens W, Graveland W, Uytdewilligen L, et al. Chromosomal anomalies in oligodendroglial tumors are correlated with clinical features. Cancer 2003;97:1276-84.
  • 9 Laghari AA, Khalid MU, Qadeer N, Shamim MS. Prognostic value of 1p/19q chromosomal codeletion in patients with oligodendroglioma. J Pak Med Assoc 2019;69:132-4.
  • 10 Brown R, Zlatescu M, Sijben A, Roldan G, Easaw J, Forsyth P, et al. The use of magnetic resonance imaging to noninvasively detect genetic signatures in oligodendroglioma. Clin Cancer Res 2008;14:2357-62.
  • 11 Megyesi JF, Kachur E, Lee DH, Zlatescu MC, Betensky RA, Forsyth PA et al. Imaging correlates of molecular signatures in oligodendrogliomas. Clin Cancer Res 2004;10:4303-6. https://pubmed.ncbi.nlm.nih.gov/15240515/.
  • 12 Preusser M, Hoeftberger R, Woehrer A, Gelpi E, Kouwenhoven M, Kros JM, et al. Prognostic value of Ki67 index in anaplastic oligodendroglial tumours – A translational study of the European Organization for Research and Treatment of Cancer Brain Tumor Group. Histopathology 2012;60:885-94.
  • 13 Abdel Razek AA, El-Serougy L, Abdelsalam M, Gaballa G, Talaat M. Differentiation of primary central nervous system lymphoma from glioblastoma: Quantitative analysis using arterial spin labeling and diffusion tensor imaging. World Neurosurg 2019;123:e303-9.
  • 14 Abdel Razek AA, Talaat M, El-Serougy L, Gaballa G, Abdelsalam M. Clinical applications of arterial spin labeling in brain tumors. J Comput Assist Tomogr 2019;43:525-32.
  • 15 Razek AA, El-Serougy LG, Abdelsalam MA, Gaballa GM, Talaat MM. Multi-parametric arterial spin labelling and diffusion-weighted magnetic resonance imaging in differentiation of grade II and grade III gliomas. Pol J Radiol 2020;85:e110-7.
  • 16 Razek AA, El-Serougy L, Abdelsalam M, Gaballa G, Talaat M. Differentiation of residual/recurrent gliomas from postradiation necrosis with arterial spin labeling and diffusion tensor magnetic resonance imaging-derived metrics. Neuroradiology 2018;60:169-77.
  • 17 El-Serougy L, Abdel Razek AA, Ezzat A, Eldawoody H, El-Morsy A. Assessment of diffusion tensor imaging metrics in differentiating low-grade from high-grade gliomas. Neuroradiol J 2016;29:400-7.
  • 18 Hilario A, Ramos A, Perez-Nuñez A, Salvador E, Millan JM, Lagares A, et al. The added value of apparent diffusion coefficient to cerebral blood volume in the preoperative grading of diffuse gliomas. Am J Neuroradiol 2012;33:701.
  • 19 Law M, Yang S, Wang H, Babb JS, Johnson G, Cha S, et al. Glioma grading: Sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging. AJNR Am J Neuroradiol 2003;24:1989-98.
  • 20 Lin Y, Xing Z, She D, Yang X, Zheng Y, Xiao Z, et al. IDH mutant and 1p/19q co-deleted oligodendrogliomas: Tumor grade stratification using diffusion-, susceptibility-, and perfusion-weighted MRI. Neuroradiology 2017;59:555-62.
  • 21 Castellano G, Bonilha L, Li LM, Cendes F. Texture analysis of medical images. Clin Radiol 2004;59:1061-9.
  • 22 Fellah S, Caudal D, De Paula AM, Dory-Lautrec P, Figarella-Branger D, Chinot O, et al. Multimodal MR imaging (diffusion, perfusion, and spectroscopy): Is it possible to distinguish oligodendroglial tumor grade and 1p/19q codeletion in the pretherapeutic diagnosis? AJNR Am J Neuroradiol 2013;34:1326-33.
  • 23 Jenkinson MD, Smith TS, Brodbelt AR, Joyce KA, Warnke PC, Walker C. Apparent diffusion coefficients in oligodendroglial tumors characterized by genotype. J Magn Reson Imaging 2007;26:1405-12.
  • 24 Pouget C, Hergalant S, Lardenois E, Lacomme S, Houlgatte R, Carpentier C, et al. Ki-67 and MCM6 labeling indices are correlated with overall survival in anaplastic oligodendroglioma, IDH1-mutant and 1p/19q-codeleted: A multicenter study from the French POLA network. Brain Pathol 2020;30:465-78. https://doi.org/10.1111/bpa.12788. https://pubmed.ncbi.nlm.nih.gov/31561286/.
  • 25 Duregon E, Bertero L, Pittaro A, Soffietti R, Rudà R, Trevisan M, et al. Ki-67 proliferation index but not mitotic thresholds integrates the molecular prognostic stratification of lower grade gliomas. Oncotarget 2016;7:21190-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008278/.
  • 26 Coons SW, Johnson PC, Pearl DK. The prognostic significance of Ki-67 labeling indices for oligodendrogliomas. Neurosurgery 1997;41:878-85.
  • 27 Liang J, Lv X, Lu C, Ye X, Chen X, Fu J. et al. Prognostic factors of patients with Gliomas- A n analysis on 335 patients with glioblastoma and other forms of gliomas. BMC Cancer 2020;20:1-7. https://pubmed.ncbi.nlm.nih.gov/31941467/.
  • 28 Latysheva A, Emblem KE, Brandal P, Vik-Mo EO, Pahnke J, Røysland K et al. Dynamic susceptibility contrast and diffusion MR imaging identify oligodendroglioma as defined by the 2016 WHO classification for brain tumors: Histogram analysis approach. Neuroradiology61(5), 545–555. [doi: 10.1007/s00234-019-02173-5]. https://pubmed.ncbi.nlm.nih.gov/30712139/.
  • 29 Anwar SS, Baig MZ, Laghari AA, Mubarak F, Shamim MS, Jilani UA, et al. Accuracy of apparent diffusion coefficients and enhancement ratios on magnetic resonance imaging in differentiating primary cerebral lymphomas from glioblastoma. Neuroradiol J 2019;32:328-34.
  • 30 Naveed MA, Goyal P. Grading of oligodendroglial tumors of the brain with apparent diffusion coefficient, magnetic resonance spectroscopy, and dynamic susceptibility contrast imaging. The neuroradiology journal, 31(4), 379–385.
  • 31 Knopp EA, Cha S, Johnson G, Mazumdar A, Golfinos JG, Zagzag D, et al. Glial neoplasms: Dynamic contrast-enhanced T2*-weighted MR imaging. Radiology 1999;211:791-8.
  • 32 McKnight TR, Lamborn KR, Love TD, Berger MS, Chang S, Dillon WP, et al. Correlation of magnetic resonance spectroscopic and growth characteristics within Grades II and III gliomas. J Neurosurg 2007;106:660-6.
  • 33 Zlatescu MC, TehraniYazdi A, Sasaki H, Megyesi JF, Betensky RA, Louis DN, et al. Tumor location and growth pattern correlate with genetic signature in oligodendroglial neoplasms. Cancer Res 2001;61:6713-5.
  • 34 Reyes-Botero G, Dehais C, Idbaih A, Martin-Duverneuil N, Lahutte M, Carpentier C, et al. Contrast enhancement in 1p/19q-codeleted anaplastic oligodendrogliomas is associated with 9p loss, genomic instability, and angiogenic gene expression. Neuro Oncol 2014;16:662-70.
  • 35 Kapoor GS, Gocke TA, Chawla S, Whitmore RG, Nabavizadeh A, Krejza J, et al. Magnetic resonance perfusion-weighted imaging defines angiogenic subtypes of oligodendroglioma according to 1p19q and EGFR status. J Neurooncol 2009;92:373-86.