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Identifying the association between contrast enhancement pattern, surgical resection, and prognosis in anaplastic glioma patients

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Abstract

Introduction

Contrast enhancement observable on magnetic resonance (MR) images reflects the destructive features of malignant gliomas. This study aimed to investigate the relationship between radiologic patterns of tumor enhancement, extent of resection, and prognosis in patients with anaplastic gliomas (AGs).

Methods

Clinical data from 268 patients with histologically confirmed AGs were retrospectively analyzed. Contrast enhancement patterns were classified based on preoperative T1-contrast MR images. Univariate and multivariate analyses were performed to evaluate the prognostic value of MR enhancement patterns on progression-free survival (PFS) and overall survival (OS).

Results

The pattern of tumor contrast enhancement was associated with the extent of surgical resection in AGs. A gross total resection was more likely to be achieved for AGs with focal enhancement than those with diffuse (p = 0.001) or ring-like (p = 0.024) enhancement. Additionally, patients with focal-enhanced AGs had a significantly longer PFS and OS than those with diffuse (log-rank, p = 0.025 and p = 0.031, respectively) or ring-like (log-rank, p = 0.008 and p = 0.011, respectively) enhanced AGs. Furthermore, multivariate analysis identified the pattern of tumor enhancement as a significant predictor of PFS (p = 0.016, hazard ratio [HR] = 1.485) and OS (p = 0.030, HR = 1.446).

Conclusion

Our results suggested that the contrast enhancement pattern on preoperative MR images was associated with the extent of resection and predictive of survival outcomes in AG patients.

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Acknowledgments

We would like to thank Dr. Q. Chen and Dr. X. Chen for their efforts in tumor segmentation. We would also acknowledge the financial support from the National High Technology Research and Development Program (2011CB707804 and 2015CB755500) and the National Natural Science Foundation of China (81271541).

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Corresponding author

Correspondence to Tao Jiang.

Ethics declarations

We declare that all human and animal studies have been approved by the Ethics Committee at Beijing Tiantan Hospital, Capital Medical University, and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

Additional information

YW and KW contributed equally to this work.

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Wang, Y., Wang, K., Wang, J. et al. Identifying the association between contrast enhancement pattern, surgical resection, and prognosis in anaplastic glioma patients. Neuroradiology 58, 367–374 (2016). https://doi.org/10.1007/s00234-016-1640-y

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  • DOI: https://doi.org/10.1007/s00234-016-1640-y

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