MRI atlas of IDH wild-type supratentorial glioblastoma: Probabilistic maps of phenotype, management, and outcomes

Alexandre Roux, Pauline Roca, Myriam Edjlali, Kanako Sato, Marc Zanello, Edouard Dezamis, Pietro Gori, Stéphanie Lion, Ariane Fleury, Frédéric Dhermain, Jean François Meder, Fabrice Chrétien, Emmanuèle Lechapt, Pascale Varlet, Catherine Oppenheim, Johan Pallud

    Résultats de recherche: Contribution à un journalArticleRevue par des pairs

    38 Citations (Scopus)

    Résumé

    Background: Tumor location is a main prognostic parameter in patients with glioblastoma. Probabilistic MRI-based brain atlases specifying the probability of tumor location associated with important demographic, clinical, histomolecular, and management data are lacking for isocitrate dehydrogenase (IDH) wild-type glioblastomas. Purpose: To correlate glioblastoma location with clinical phenotype, surgical management, and outcomes by using a probabilistic analysis in a three-dimensional (3D) MRI-based atlas. Materials and Methods: This retrospective study included all adults surgically treated for newly diagnosed IDH wild-type supratentorial glioblastoma in a tertiary adult surgical neuro-oncology center (2006-2016). Semiautomated tumor segmentation and spatial normalization procedures to build a 3D MRI-based atlas were validated. The authors performed probabilistic analyses by using voxel-based lesion symptom mapping technology. The Liebermeister test was used for binary data, and the generalized linear model was used for continuous data. Results: A total of 392 patients (mean age, 61 years 6 13; 233 men) were evaluated. The authors identified the preferential location of glioblastomas according to subventricular zone, age, sex, clinical presentation, revised Radiation Therapy Oncology Group-Recursive Partitioning Analysis class, Karnofsky performance status, O6-methylguanine DNA methyltransferase promoter methylation status, surgical management, and survival. The superficial location distant from the eloquent area was more likely associated with a preserved functional status at diagnosis (348 of 392 patients [89%], P , .05), a large surgical resection (173 of 392 patients [44%], P , .05), and prolonged overall survival (163 of 334 patients [49%], P , .05). In contrast, deep location and location within eloquent brain areas were more likely associated with an impaired functional status at diagnosis (44 of 392 patients [11%], P , .05), a neurologic deficit (282 of 392 patients [72%], P , .05), treatment with biopsy only (183 of 392 patients [47%], P , .05), and shortened overall survival (171 of 334 patients [51%], P , .05). Conclusion: The authors identified the preferential location of isocitrate dehydrogenase wild-type glioblastomas according to parameters of interest and provided an image-based integration of multimodal information impacting survival results. This suggests the role of glioblastoma location as a surrogate and multimodal parameter integrating several known prognostic factors.

    langue originaleAnglais
    Pages (de - à)633-643
    Nombre de pages11
    journalRadiology
    Volume293
    Numéro de publication3
    Les DOIs
    étatPublié - 1 janv. 2019

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