title: Patterns of Tumor Contrast Enhancement Predict the Prognosis of Anaplastic Gliomas with IDH1 Mutation.
abstract: OBJECTIVE
  It is proposed that isocitrate dehydrogenase 1 (IDH1) mutation predicts the outcome in patients with high-grade glioma. In addition, contrast enhancement on preoperative MR imaging reflects tumor biologic features. Patients with anaplastic glioma with the IDH1 mutation were evaluated by using MR imaging to determine whether tumor enhancement is a prognostic factor and can be used to predict survival.
  
  
  METHODS
  A cohort of 216 patients with histologically confirmed anaplastic glioma was reviewed retrospectively. Tumor contrast-enhancement patterns were classified on the basis of preoperative T1 contrast MR images. Tumor IDH1 status was examined by using RNA sequencing. We used univariate analysis and the multivariate Cox model to evaluate the prognostic value of the IDH1 mutation and tumor contrast-enhancement pattern for progression-free survival and overall survival.
  
  
  RESULTS
  In all 216 patients, IDH1 mutation was associated with longer progression-free survival (P = .004, hazard ratio = 0.439) and overall survival (P = .002, hazard ratio = 0.406). For patients with IDH1 mutant anaplastic glioma, the absence of contrast enhancement was associated with longer progression-free survival (P = .038, hazard ratio = 0.473) and overall survival (P = .043, hazard ratio = 0.436). Furthermore, we were able to stratify the progression-free survival and overall survival of patients with IDH1 mutation by using the tumor contrast-enhancement patterns (P = .022 and 0.029, respectively; log-rank).
  
  
  CONCLUSIONS
  Tumor enhancement on postcontrast MR imaging is a valuable prognostic factor for patients with anaplastic glioma and IDH1 mutation. Furthermore, the contrast-enhancement patterns could potentially be used to stratify the survival outcome of such patients.
authors: From the Departments of Neurosurgery (Y.Y.W., J.F.W., T.J.) Beijing Neurosurgical Institute (Y.Y.W., T.J., J.P.D.), Capital Medical University, Beijing, China.
authors: Y Y
authors: YY
authors: Wang
authors: Neuroradiology (K.W., S.W.L., J.M., J.P.D.), Beijing Tian Tan Hospital.
authors: K
authors: K
authors: Wang
authors: Neuroradiology (K.W., S.W.L., J.M., J.P.D.), Beijing Tian Tan Hospital.
authors: S W
authors: SW
authors: Li
authors: From the Departments of Neurosurgery (Y.Y.W., J.F.W., T.J.).
authors: J F
authors: JF
authors: Wang
authors: Neuroradiology (K.W., S.W.L., J.M., J.P.D.), Beijing Tian Tan Hospital.
authors: J
authors: J
authors: Ma
authors: From the Departments of Neurosurgery (Y.Y.W., J.F.W., T.J.) Beijing Neurosurgical Institute (Y.Y.W., T.J., J.P.D.), Capital Medical University, Beijing, China Center for Brain Tumor (T.J.), Beijing Institute for Brain Disorders, Beijing, China. taojiang1964@163.com djpbeijing@hotmail.com.
authors: T
authors: T
authors: Jiang
authors: Neuroradiology (K.W., S.W.L., J.M., J.P.D.), Beijing Tian Tan Hospital Beijing Neurosurgical Institute (Y.Y.W., T.J., J.P.D.), Capital Medical University, Beijing, China taojiang1964@163.com djpbeijing@hotmail.com.
authors: J P
authors: JP
authors: Dai
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D005910:Glioma / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D006801:Humans; D007521:Isocitrate Dehydrogenase / Q000235:genetics*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies
chemical_list: D007521:Isocitrate Dehydrogenase; C543588:IDH1 protein, human