title: Identifying the association between contrast enhancement pattern, surgical resection, and prognosis in anaplastic glioma patients.
abstract: BACKGROUND
  Contrast enhancement observable on magnetic resonance (MR) images reflects the destructive features of malignant gliomas. This study aimed to investigate the relationship between radiologic patterns of tumor enhancement, extent of resection, and prognosis in patients with anaplastic gliomas (AGs).
  
  
  METHODS
  Clinical data from 268 patients with histologically confirmed AGs were retrospectively analyzed. Contrast enhancement patterns were classified based on preoperative T1-contrast MR images. Univariate and multivariate analyses were performed to evaluate the prognostic value of MR enhancement patterns on progression-free survival (PFS) and overall survival (OS).
  
  
  RESULTS
  The pattern of tumor contrast enhancement was associated with the extent of surgical resection in AGs. A gross total resection was more likely to be achieved for AGs with focal enhancement than those with diffuse (p = 0.001) or ring-like (p = 0.024) enhancement. Additionally, patients with focal-enhanced AGs had a significantly longer PFS and OS than those with diffuse (log-rank, p = 0.025 and p = 0.031, respectively) or ring-like (log-rank, p = 0.008 and p = 0.011, respectively) enhanced AGs. Furthermore, multivariate analysis identified the pattern of tumor enhancement as a significant predictor of PFS (p = 0.016, hazard ratio [HR] = 1.485) and OS (p = 0.030, HR = 1.446).
  
  
  CONCLUSIONS
  Our results suggested that the contrast enhancement pattern on preoperative MR images was associated with the extent of resection and predictive of survival outcomes in AG patients.
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.|Beijing Neurosurgical Institute, Capital Medical University, 6, Tiantanxili, Beijing, 100050, China.
authors.forename: Yinyan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Jiangfei
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Shaowu
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, 6, Tiantanxili, Beijing, 100050, China.|Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Dai
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. taojiang1964@163.com.|Beijing Neurosurgical Institute, Capital Medical University, 6, Tiantanxili, Beijing, 100050, China. taojiang1964@163.com.
authors.forename: Tao
authors.initials: T
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000708:Anaplasia; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D005910:Glioma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: Anaplastic glioma; Contrast enhancement; Magnetic resonance imaging; Pattern; Survival