Patterns of Tumor Contrast Enhancement Predict the Prognosis of Anaplastic Gliomas with IDH1 Mutation

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Fig 1.
Tumor contrast-enhancement patterns in AG. Postcontrast T1-weighted images depict the nodular (largest focal diameter of ≤1.5 cm), patchy (largest focal diameter of >1.5 cm), and ringlike (cystic necrosis with peripheral enhancement) enhancement patterns.
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Fig 2.
Constitution of tumor contrast enhancements between AG accompanied by mutant or wild type IDH1. The difference in contrast-enhancement rate (asterisk) between tumors from patients with mutant and wild type IDH1 was significant (P < .001). There was no significant difference in enhancement-pattern distribution between tumors from patients with mutant and wild type IDH1 (P = .135). CE indicates contrast enhancement.
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Fig 4.
Kaplan-Meier plots showing that the tumor contrast enhancement pattern enabled stratification of the PFS and OS of patients with mutant IDH1 (PFS, P = .022; OS, P = .029). Meanwhile, Kaplan-Meier plots show that the tumor contrast-enhancement pattern did not enable stratification of the PFS and OS of patients with wild type IDH1 (PFS, P = .896; OS, P = .842).

Table 1:

IDH1 mutation status of patients with AG

Note:—AA indicates anaplastic astrocytomas; AO, anaplastic oligodendrogliomas; AOA, anaplastic oligoastrocytomas.
↵a Results of the χ² test.

Table 2:

Univariate analysis of survival outcomes for patients with AG

Table 3:

Multivariate analysis of survival outcomes

Predictor	P Value^{^a}	HR	95% CI
PFS
Age 50 yr or older	.018	1.857	1.111–3.106
Preoperative KPS < 80	.015	2.158	1.179–3.471
<GTR	.028	1.598	1.053–2.597
IDH1 wild type	.004	2.277	1.303–3.968
OS
Age 50 yr or older	.016	1.431	1.342–2.434
Preoperative KPS < 80	.026	1.836	1.087–3.402
<GTR	.023	1.488	1.210–2.432
IDH1 wild-type	.002	2.463	1.389–4.386