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Extension of diffuse low-grade gliomas beyond radiological borders as shown by the coregistration of histopathological and magnetic resonance imaging data
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery. Uppsala Univ Hosp, Dept Neurosurg, Uppsala, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology. Univ Uppsala Hosp, Dept Neurol, Uppsala, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology. Uppsala University, Science for Life Laboratory, SciLifeLab.
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2016 (English)In: Journal of Neurosurgery, ISSN 0022-3085, E-ISSN 1933-0693, Vol. 125, no 5, 1155-1166 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE Magnetic resonance imaging tends to underestimate the extent of diffuse low-grade gliomas (DLGGs). With the aim of studying the presence of tumor cells outside the radiological border, the authors developed a method of correlating MRI findings with histological data in patients with suspected DLGGs in whom en bloc resections were performed. METHODS Five patients with suspected DLGG suitable for en bloc resection were recruited from an ongoing prospective study. Sections of the entire tumor were immunostained with antibodies against mutated IDH1 protein (IDH1-R132H). Magnetic resonance images were coregistered with corresponding IDH1 images. The growth pattern of tumor cells in white and gray matter was assessed in comparison with signal changes on corresponding MRI slices. RESULTS Neuropathological assessment revealed DLGG in 4 patients and progression to WHO Grade III glioma in 1 patient. The tumor core consisted of a high density of IDH1-R132H-positive tumor cells and was located in both gray and white matter. Tumor cells infiltrated along the peripheral fibers of the white matter tracts. In all cases, tumor cells were found outside the radiological tumor border delineated on T2-FLAIR MRI sequences. CONCLUSIONS The authors present a new method for the coregistration of histological and radiological characteristics of en bloc-removed infiltrative brain tumors that discloses tumor invasion at the radiological tumor borders. This technique can be applied to evaluate the sensitivity of alternative imaging methods to detect scattered tumor cells at tumor borders. Accurate methods for detection of infiltrative tumor cells will improve the possibility of performing radical tumor resection. In future studies, the method could also be used for in vivo studies of tumor invasion.

Place, publisher, year, edition, pages
2016. Vol. 125, no 5, 1155-1166 p.
Keyword [en]
diffuse low-grade glioma; magnetic resonance imaging; tumor border; tumor cell infiltration; oncology
National Category
Neurology
Identifiers
URN: urn:nbn:se:uu:diva-281052DOI: 10.3171/2015.10.JNS15583ISI: 000386106100013PubMedID: 26918468OAI: oai:DiVA.org:uu-281052DiVA: diva2:912639
Available from: 2016-03-17 Created: 2016-03-17 Last updated: 2017-11-30Bibliographically approved

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Zetterling, MariaRoodakker, Kenney R.Berntsson, Shala GhaderiEdqvist, Per-Henrik DLatini, FrancescoLandtblom, Anne-MariePontén, FredrikAlafuzoff, IrinaLarsson, Elna-MarieSmits, Anja

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Zetterling, MariaRoodakker, Kenney R.Berntsson, Shala GhaderiEdqvist, Per-Henrik DLatini, FrancescoLandtblom, Anne-MariePontén, FredrikAlafuzoff, IrinaLarsson, Elna-MarieSmits, Anja
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NeurosurgeryNeurologyExperimental and Clinical OncologyScience for Life Laboratory, SciLifeLabClinical and experimental pathologyRadiology
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