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Research ArticleBRAIN TUMOR IMAGING

Ten Years of VASARI Glioma Features: Systematic Review and Meta-Analysis of Their Impact and Performance

Aynur Azizova, Yeva Prysiazhniuk, Ivar J.H.G. Wamelink, Jan Petr, Frederik Barkhof and Vera C. Keil
American Journal of Neuroradiology June 2024, DOI: https://doi.org/10.3174/ajnr.A8274
Aynur Azizova
aFrom the Radiology and Nuclear Medicine Department (A.A., I.J.H.G.W., J.P., F.B., V.C.K.), Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
bImaging and Biomarkers (A.A., I.J.H.G.W., V.C.K.), Cancer Center Amsterdam, Amsterdam, the Netherlands
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  • ORCID record for Aynur Azizova
Yeva Prysiazhniuk
cThe Second Faculty of Medicine (Y.P.), Department of Pathophysiology, Charles University, Prague, Czech Republic
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Ivar J.H.G. Wamelink
aFrom the Radiology and Nuclear Medicine Department (A.A., I.J.H.G.W., J.P., F.B., V.C.K.), Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
bImaging and Biomarkers (A.A., I.J.H.G.W., V.C.K.), Cancer Center Amsterdam, Amsterdam, the Netherlands
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Jan Petr
aFrom the Radiology and Nuclear Medicine Department (A.A., I.J.H.G.W., J.P., F.B., V.C.K.), Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
dInstitute of Radiopharmaceutical Cancer Research (J.P.), Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
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Frederik Barkhof
aFrom the Radiology and Nuclear Medicine Department (A.A., I.J.H.G.W., J.P., F.B., V.C.K.), Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
eBrain Imaging (F.B., V.C.K.), Amsterdam Neuroscience, Amsterdam, the Netherlands
fQueen Square Institute of Neurology and Center for Medical Image Computing (F.B.), University College London, London, United Kingdom
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Vera C. Keil
aFrom the Radiology and Nuclear Medicine Department (A.A., I.J.H.G.W., J.P., F.B., V.C.K.), Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
bImaging and Biomarkers (A.A., I.J.H.G.W., V.C.K.), Cancer Center Amsterdam, Amsterdam, the Netherlands
eBrain Imaging (F.B., V.C.K.), Amsterdam Neuroscience, Amsterdam, the Netherlands
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Article Figures & Data

Figures

  • FIG 1.
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    FIG 1.

    PRISMA flow chart describing the literature-selection process.

  • FIG 2.
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    FIG 2.

    The association between different VASARI features and OS (A), progression-free survival (B), and IDH mutation status (C) listed per study involving glioblastoma and grades 1–4 glioma cohorts. Green indicates tested and significant feature; red, tested and nonsignificant feature or feature with statistical results not provided; gray, features not tested. The list of VASARI features and their detailed descriptions, along with respective scoring systems for each feature are in the Online Supplemental Data.

  • FIG 3.
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    FIG 3.

    Meta-analysis of OS-predicting studies with a pooled HR >1.25. Note that the list of VASARI features and their detailed descriptions, along with respective scoring systems for each feature are provided in Online Supplemental Data. f indicates VASARI feature; f3, eloquent brain; f9, multifocality; f11, thickness of enhancing margin; f13, definition of nonenhancing margin; f19, ependymal invasion; f21, deep white matter invasion; f23, enhancing tumor crosses the midline; f24, satellites.

  • FIG 4.
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    FIG 4.

    Meta-analysis of OS-predicting studies with a pooled HR ≤ 1.25. Note that the list of VASARI features and their detailed descriptions, along with respective scoring systems for each feature are provided in the Online Supplemental Data. f indicates VASARI feature; f4, enhancement quality; f8, cysts; f10, T1/FLAIR ratio; f16, hemorrhage; f18,pial invasion; f20, cortical involvement; f22, nonenhancing tumor crosses midline.

  • FIG 5.
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    FIG 5.

    Color table describing HRs of single VASARI features in OS-predicting studies using univariable Cox proportional models. Thresholds of single HRs were defined arbitrarily, and each color represents a different range: blue, HR <0.75; green, HR 0.75 to <0.85; light red, HR 0.85–1.25; orange, HR >1.25–2.5; dark red, HR >2.5. Values highlighted in bold indicate HRs with statistical significance (P value < .05). The list of VASARI features and their detailed descriptions, along with respective scoring systems for each feature, are provided in the Online Supplemental Data.

  • FIG 6.
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    FIG 6.

    Meta-analysis of glioma IDH mutation status–predicting studies. The list of VASARI features and their detailed descriptions, along with respective scoring systems for each feature, are provided in the Online Supplemental Data. IDHwt indicates IDH wild-type; IDHmut, IDH-mutant.

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Cite this article
Aynur Azizova, Yeva Prysiazhniuk, Ivar J.H.G. Wamelink, Jan Petr, Frederik Barkhof, Vera C. Keil
Ten Years of VASARI Glioma Features: Systematic Review and Meta-Analysis of Their Impact and Performance
American Journal of Neuroradiology Jun 2024, DOI: 10.3174/ajnr.A8274

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Ten Years of VASARI Glioma Features: Systematic Review and Meta-Analysis of Their Impact and Performance
Aynur Azizova, Yeva Prysiazhniuk, Ivar J.H.G. Wamelink, Jan Petr, Frederik Barkhof, Vera C. Keil
American Journal of Neuroradiology Jun 2024, DOI: 10.3174/ajnr.A8274
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