Related Experiment Video
Updated: May 13, 2026
A Protocol for Explant Cultures of IDH1-mutant Diffuse Low-grade Gliomas
Published on: May 9, 2025
A single-institution retrospective study of multicentric gliomas stratified by IDH mutational status
Chuyin Yang1, Ryan Mostafavi1, Collin Le1
1Department of Neurology, University of California, Los Angeles, Los Angeles, California, USA.
Background:
Multicentric glioma (MCG) are defined radiographically as two or more tumor foci with separation of MRI T2-FLAIR (T2-weighted Fluid-attenuated Inversion Recovery) hyperintensities presenting synchronously (sMCG) and/or metachronously (mMCG). Previous studies have not stratified isocitrate dehydrogenase (IDH) wild-type and mutant gliomas by sMCG and mMCG. In this large, single-institution cohort stratified by IDH status, we evaluated MCG prevalence, prognostic implications, time to mMCG (TtM), location, and pathological concordance.
Methods:
We identified 836 IDH wild-type and 531 IDH mutant diffuse glioma patients treated at our institution with evaluable MRI. We inspected MRIs at presentation for sMCG and subsequent imaging for mMCG, reviewed radiology and pathology reports, and performed overall survival (OS) and TtM analyses.
Results:
MCG prevalence was higher in IDH wild-type cases (18%) than in IDH mutant cases (9%) (P < .0001). We found 20 sMCG and 26 mMCG in IDH mutant and 91 sMCG and 54 mMCG in IDH wild-type patients. In 7 wild-type and 1 mutant instances, mMCG arose from sMCG (smMCG). While sMCG and mMCG were associated with lower OS in IDH wild-type cases (sMCG: HR = 1.46, P = .003; mMCG: HR = 1.44, P = .02), only mMCG was associated with lower OS in IDH mutant cases (sMCG: HR = 1.22, P = .7; mMCG: HR = 2.64, P = .001). IDH wild-type cases had shorter TtM than mutant cases (P < .0001). Among double-biopsied MCG, pathology discordance occurred in 5/7 mutant but 0/28 wild-type cases.
Conclusion:
Results from this cohort of diffuse gliomas stratified by IDH status showed differences between IDH wild-type and mutant cohorts in prevalence, prognosis, TtM, distribution, and pathological concordance.
Insights
Multicentric glioma (MCG) is more common in isocitrate dehydrogenase (IDH) wild-type gliomas and impacts overall survival. IDH wild-type gliomas also show a shorter time to multicentric glioma development and higher pathological concordance.
Area of Science:
- Neuro-oncology
- Radiology
- Pathology
Background:
- Multicentric glioma (MCG) is defined by multiple tumor foci on MRI T2-FLAIR.
- Previous research has not stratified gliomas by IDH status and MCG presentation (synchronous/metachronous).
Purpose of the Study:
- To evaluate MCG prevalence, prognostic implications, time to multicentric glioma (TtM), and pathological concordance in IDH wild-type versus IDH mutant diffuse gliomas.
- To stratify findings by synchronous MCG (sMCG) and metachronous MCG (mMCG).
Main Methods:
- Retrospective analysis of 836 IDH wild-type and 531 IDH mutant diffuse glioma patients.
- Review of MRIs for sMCG and subsequent imaging for mMCG.
- Analysis of overall survival (OS) and TtM, stratified by IDH status.
Main Results:
- MCG prevalence was higher in IDH wild-type (18%) than IDH mutant (9%) gliomas.
- sMCG and mMCG were associated with lower OS in IDH wild-type cases; only mMCG impacted OS in IDH mutant cases.
- IDH wild-type cases had shorter TtM, and pathology discordance was higher in double-biopsied IDH mutant MCG.
Conclusions:
- Significant differences exist between IDH wild-type and mutant gliomas regarding MCG prevalence, prognosis, TtM, and pathological concordance.
- Findings highlight the importance of IDH status in understanding MCG behavior and outcomes.
