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Diffuse glioma, not otherwise specified: imaging-based risk stratification achieves histomolecular-level
Eun Bee Jang1, Ho Sung Kim2, Ji Eun Park1
1Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
European Radiology
|May 19, 2022
Summary
Imaging-based risk stratification accurately predicts outcomes for diffuse glioma, not otherwise specified (NOS). This approach offers similar prognostic performance to molecular methods and can guide patient management when molecular diagnosis is challenging.
Area of Science:
- Neuro-oncology
- Radiology
- Oncologic imaging
Background:
- Diffuse glioma, not otherwise specified (NOS), presents a diagnostic challenge.
- Accurate prognostication is crucial for guiding treatment strategies in diffuse glioma, NOS.
- Current prognostication often relies on molecular markers, which may not always be readily available.
Purpose of the Study:
- To evaluate the efficacy of imaging-based risk stratification for prognostication in diffuse glioma, NOS.
- To compare the prognostic performance of an imaging-based model with a historical molecular-based model.
Main Methods:
- Retrospective analysis of 220 diffuse glioma, NOS cases (2011-2020).
- Two neuroradiologists assigned risk types (low, intermediate, high) based on pre-surgical CT and MRI phenotypes.
- Progression-free survival (PFS) and overall survival (OS) were analyzed; time-dependent ROC analysis compared imaging vs. molecular models.
Main Results:
- Imaging-based risk stratification significantly predicted both PFS and OS (log-rank test, p < 0.001).
- The imaging-based survival model demonstrated strong prognostic value, with AUCs for 1-year PFS (0.772) and OS (0.650).
- Long-term prognostication showed high performance: 3-year PFS (AUC = 0.806) and 5-year OS (AUC = 0.812), comparable to a historical molecular model.
Conclusions:
- Imaging-based risk stratification effectively achieves histomolecular-level prognostication in diffuse glioma, NOS.
- This imaging approach provides prognostic performance comparable to established molecular-based models.
- Imaging-based risk stratification can assist in patient referral and management, especially when molecular diagnosis is insufficient or unsuccessful.
