Comparison of Immunogenetic Properties of Glial Tumors with Advanced Magnetic Resonance Imaging Findings

Özet

AIM: To investigate the immunogenetic properties of glial tumors according to the World Health Organization 2016 glial tumorclassification and develop an accurate diagnosis and treatment strategy by comparing preoperative advanced magnetic resonance(aMRI) technique findings of these results.MATERIAL and METHODS: This study was conducted at the Department of Neurosurgery at the Medical Faculty Hospital of SelcukUniversity between January 1, 2010 and January 4, 2017 and included 50 patients. MR spectroscopy (MRS), MR perfusion (PWI),and MR diffusion (DWI) were performed in 50 patients preoperatively. Patient data were obtained from the hospital’s informationsystem. Pathological diagnosis of all patients was taken from the department of pathology at the same medical faculty.RESULTS: Among the patients included in the study, 11 were grade II (22%), 7 were grade III (14%), and 32 were grade IV (64%). Allpatients were IDH1 stained: 22 were IDH mutant (44%) and 28 were IDH wild-type (56%). A statistically significant difference in thesurvival time was observed between IDH mutant and wild-type. IDH-mutant tumors were commonly located in the frontal lobe andIDH wild-type tumors in the parietal and temporal lobes. A significant difference in PWI relative cerebral blood volume (rCBV) andDWI apparent diffusion coefficients (ADC) was noted among grade II, III, and IV tumor groups. The PWI rCBV cut-off value for gradeIV tumors was 2.05 (90% sensitivity, 78% specificity). No difference in the Cho/Cr ratio among grade II, III, and IV tumor groups wasnoted. A significant difference was noted between the IDH mutant and wild type in terms of PWI rCBV. The PWI rCBV cut-off valueof IDH mutant–wild type was 2.15. No difference in the Cho/Cr, Cho/NAA, and DWI apparent diffusion coefficients (p>0.05) wasnoted between the IDH mutant and wild type.CONCLUSION: PWI rCBV is the most important prognostic value of aMRI used in tumor grading. PWI rCBV values could besignificant in distinguishing IDH wild and mutant.