MR imaging correlation of survival in patients with high-grade gliomas

Abstract

Background: Gliomas are the most common, primary brain tumors, and approximately 80% are malignant and have a poor prognosis. Treatment and prognosis of brain tumors differ depending on the type of tumor and degree of malignancy, and it is important to diagnose the tumor at an early stage by its unique imaging features. According to the WHO classification of central nervous system tumors, gliomas are classified into grades I-IV, and in clinical practice they are usually classified as benign (I, II) and malignant (III, IV). Magnetic resonance imaging (MRI) is a widely used technique that has been employed in the non-invasively diagnosing, management and follow-up of gliomas in clinical practice.5, 6 Conventional MRI modalities including T1-weighted (T1), post-contrast enhanced T1-weighted (T1-Gd), T2-weighted and T2-FLAIR images are used for tumor evaluation. These MRI images provide anatomical characteristics of brain tumors. In addition, advanced MRI modalities like perfusion weighted, diffusion-weighted, diffusion tensor-weighted, and MR spectroscopic imaging etc. provide further microvascular, microstructural, and biochemical information. Aim: To investigate the survival time of patients diagnosed with malignant brain glioma compared with imaging features on MRI. Materials and Methods: The study was conducted between 2018 and 2022 by sampling 54 clients who were diagnosed with malignant glioma brain tumor by undergoing MRI scan at Mongolia Japan hospital-MNUMS, Medportal and Grandmed hospitals. Retrospective cohort analysis was done selecting 25 cases according to the inclusion and exclusion criteria. Results: Total of 25 cases, 19 (76%) were male and 6 (24%) were female, with a median age of 50.3±21.7 years. The 1 month, 3 months, 6 months, 9 months, 1 year, 3 years, and 5 years survival rates were 92%, 72%, 56%, 48%, 40%, 12%, and 0%, respectively. The median survival after diagnosis was 14.1 months. According to the comparison of survival rate with MRI imaging features, the tumor volume (P<0.024), numerous hemorrhage (P<0.04), high edema index (P<0.02), and necrosis content (p<0.001) were affecting the prognosis. Conclusions: 1. The volume of brain tumors detected in some MRI sequences, surrounding edema, and tumor contents are factors that affect the high-grade gliomas survival rate. 2. Studying the symptoms that negatively affect the quality of life of people with high grade glioma with the help of MRI analysis will help to predict the prognosis of the disease early, choose the optimal treatment plan, evaluate the treatment results, prevent complications, and improve the prognosis.