Turkish Neurosurgery 2020 , Vol 30 , Num 3
Comparison of Immunogenetic Properties of Glial Tumors with Advanced Magnetic Resonance Imaging Findings
Burak GEZER1,Ali MUTLUKAN2,Mert SAHINOGLU3,Pınar KARABAGLI4,Ender KOKTEKIR3,Hakan KARABAGLI3
1Tatvan State Hospital, Department of Neurosurgery, Bitlis, Turkey
2Serik State Hospital, Department of Neurosurgery, Antalya, Turkey
3Selcuk University, Faculty of Medicine, Department of Neurosurgery, Konya, Turkey
4Selcuk University, Faculty of Medicine, Department of Pathology, Konya, Turkey
DOI : 10.5137/1019-5149.JTN.27261-19.3 AIM: To investigate the immunogenetic properties of glial tumors according to the World Health Organization 2016 glial tumor classification and develop an accurate diagnosis and treatment strategy by comparing preoperative advanced magnetic resonance (aMRI) technique findings of these results.

MATERIAL and METHODS: This study was conducted at the Department of Neurosurgery at the Medical Faculty Hospital of Selcuk University between January 1, 2010 and January 4, 2017 and included 50 patients. MR spectroscopy (MRS), MR perfusion (PWI), and MR diffusion (DWI) were performed in 50 patients preoperatively. Patient data were obtained from the hospital’s information system. Pathological diagnosis of all patients was taken from the department of pathology at the same medical faculty.

RESULTS: Among the patients included in the study, 11 were grade II (22%), 7 were grade III (14%), and 32 were grade IV (64%). All patients were IDH1 stained: 22 were IDH mutant (44%) and 28 were IDH wild-type (56%). A statistically significant difference in the survival time was observed between IDH mutant and wild-type. IDH-mutant tumors were commonly located in the frontal lobe and IDH wild-type tumors in the parietal and temporal lobes. A significant difference in PWI relative cerebral blood volume (rCBV) and DWI apparent diffusion coefficients (ADC) was noted among grade II, III, and IV tumor groups. The PWI rCBV cut-off value for grade IV tumors was 2.05 (90% sensitivity, 78% specificity). No difference in the Cho/Cr ratio among grade II, III, and IV tumor groups was noted. A significant difference was noted between the IDH mutant and wild type in terms of PWI rCBV. The PWI rCBV cut-off value of IDH mutant–wild type was 2.15. No difference in the Cho/Cr, Cho/NAA, and DWI apparent diffusion coefficients (p>0.05) was noted between the IDH mutant and wild type.

CONCLUSION: PWI rCBV is the most important prognostic value of aMRI used in tumor grading. PWI rCBV values could be significant in distinguishing IDH wild and mutant. Keywords : Isocitratedehydrogenase mutation, Magnetic resonance spectroscopy, Magnetic resonance perfusion, Magnetic resonance diffusion

Corresponding author : Ender KOKTEKIR, enderkoktekirnrs@hotmail.com