Unravelling differences and hallmarks in suspected diffuse low-grade gliomas: a multicentre database study.

Area of Science:

• Neuro-oncology
• Radiology
• Molecular Pathology

Background:

• Diffuse low-grade gliomas (DLGG) natural history is influenced by molecular status.
• Preoperative clinical and radiological data integration may enhance understanding of DLGG.
• Identifying distinct phenotypes for DLGG molecular subgroups is crucial for prognosis.

Purpose of the Study:

• To systematically analyze clinical and radiological phenotypes of DLGG molecular subgroups at diagnosis.
• To identify differences in age, tumor location, onset symptoms, and cognitive status among DLGG molecular subgroups.
• To explore the utility of integrated clinico-radiological approaches for DLGG prediction models.

Main Methods:

• Analysis of 235 patients with World Health Organization (WHO) grade 2 gliomas from nine Scandinavian centers.
• Inclusion of patients with known isocitrate dehydrogenase (IDH) status and 1p19q codeletion status.
• Utilized MRI-based tumor volume segmentation, Brain-Grid (BG) system for invasiveness analysis, and regression analyses.

Main Results:

• Three molecular subgroups (IDH-mutated astrocytomas, oligodendrogliomas, IDH-wildtype astrocytomas) showed significant differences in age, location, onset, and cognitive status.
• Seizure onset correlated with BG voxel count and specific locations (A3C2S2).
• Cognitive deficits related to age, gender, and tumor volume, with specific white matter tract infiltrations predicting subgroups.

Conclusions:

• Integrated clinico-radiological analysis identified distinct phenotypes across DLGG molecular subgroups.
• Patient-specific (age, onset) and tumor-specific (location, infiltration) features are relevant for preoperative DLGG understanding.
• Combining clinical and radiological data offers potential for improved DLGG prediction models and understanding of onco-functional trajectory.