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1、中国脑胶质瘤图谱计划中国脑胶质瘤图谱计划 胶质瘤基因表达与影像学之间的联系 文献回顾及展望 北京市神经外科研究所 中国脑胶质瘤图谱计划 Star markers and Common imaging Star markers: -MGMT -IDH1 -EGFR -1p/19q -TP53 -Ki-67 -PTEN -MIB-1 -Others -Types Common imaging: -T1/T2 -T1+ -FLAIR -CBV -DTI/DWI -DCE-MR -MRS -PET -SPECT 中国脑胶质瘤图谱计划 IDH11p/19qEGFRP53MGMT T1/T2 1.Albe
2、rt Lai,et al 2011 2.Carrillo, J. A.,et al 2012 3.Metellus, Philippe,et al 2010 1.Metellus, Philippe,et al 2010 2.Megyesi JF,et al 2004 3.Kim JW,et al 2011 1.Diehn, Maximilian,et al 2008 2.Shazeeb MS, et al 2011 3.Mu, Ketao，et al 2015 1.Wang, Y Y,et al 2014 2.Wang, Y Y,et al 2015 1.Carrillo JA,et al
3、2012 2.Sunwoo L,et al 2013 3.Ahn, Sung Soo,et al 2014 FLAIR 1.Ellingson BM,et al 2013 2.Metellus, Philippe,et al 2010 3.Pope, W. B,et al 2012 1.Metellus, Philippe,et al 2010 1.Ellingson BM,et al 2013 1.Liu C,et al 2012 1.Ellingson BM,et al 2013 T1+ 1.Albert Lai,et al 2011 2.Ellingson BM,et al 2013 3
4、.Metellus, Philippe,et al 2010 1.Metellus, Philippe,et al 2010 1.Ellingson BM,et al 2013 1.Sunwoo L,et al 2013 2.Ahn, Sung Soo,et al 2014 3.Ellingson BM,et al 2013 DTI 1.Tan, W L,et al 2014 1.Ahn, Sung Soo,et al 2014 DWI(ADC) 1.Sunwoo L,et al 2013 CBV MRS 1.Pope, W. B,et al 2012 DCE-MRI 1.Ahn, Sung
5、Soo,et al 2014 PET SPECT Star markers and Common imaging 中国脑胶质瘤图谱计划 PTENMIB-1Ki-67OthersTypes T1/T2 1.Jamshidi N,et al 2012 2.Gevaert, Olivier,et al 2014 3.Fan, Xing,et al 2015 1.Naeini KM, et al 2013 FLAIR 1.Liu C, et al 2012 1.Gevaert, Olivier,et al 2014 T1+ DTI 1.Bell, C.et al 2014 DWI(ADC) 1.Zik
6、ou, A. K.,et al 2012 CBV 1.Zikou, A. K.,et al 2012 MRS 1.Yu TG,et al 2015 DCE-MRI PET SPECT Star markers and Common imaging 中国脑胶质瘤图谱计划 MGMT 1、水肿很少出现甚至不会出现在甲基化的肿瘤周围4 。 2、MGMT状态需要纹理特征分析才能够建立与MRI特征的联系8、9 。 3、MGMT与ADC呈正相关，ADC与PFS呈正相关10。 4、MGMT甲基化的肿瘤容易出现在左侧颞叶，而MGMT非甲基化的 肿瘤更倾向于长在右侧半球3 。 5、MGMT非甲基化和EGFR扩增的
7、肿瘤容易生长在右侧岛叶，丘脑， 颞叶并向侧脑室后部室管膜下区延伸10 。 6、非甲基化的MGMT肿瘤在T1增强和T2/FLAIR像上比MGMT甲基化 的肿瘤强化面积大3 。 中国脑胶质瘤图谱计划 Probabilistic Radiographic Atlas of Glioblastoma Phenotypes B.M. Ellingson. et al, AJNR,2013 MGMT promoter methylated tumors occur more frequently in the left temporal lobe 中国脑胶质瘤图谱计划 t-value Prediction
8、 of methylguanine methyltransferase promoter methylation in glioblastoma using dynamic contrast-enhanced magnetic resonance and diffusion tensor imaging SungSoo Ahn. et al, J Neurosurg ,2014 DCE-MRI permeability parameters: Ktrans may serve as a potential imaging biomarker to predict MGMT methylatio
9、n status in glioblastoma. 中国脑胶质瘤图谱计划 Correlation of Apparent Diffusion Coefficient Values Measured by Diffusion MRI and MGMT Promoter Methylation Semiquantitatively Analyzed With MS-MLPA in Patients With Glioblastoma Multiforme methylated MGMT Un-methylated MGMT T1WADC The mean ADC revealed a positi
10、ve relationship with MGMT promoter methylation ratio Leonard Sunwoo et al, Journal MRI ,2012 中国脑胶质瘤图谱计划 IDH1 1、IDH1突变的肿瘤好发于额叶而且肿瘤细胞临近脑室下区3，3 。 2、用标准的MRI特征就可预测IDH1的表达状态4。 3、在DTI相中，利用部分异向分数和ADC可以在星形细胞胶质瘤 中监测IDH1 R132H的突变情况5。 4、随着年龄上升，IDH1突变减少，肿瘤更容易长在岛叶并且 1p/19q均表现为阴性6。 中国脑胶质瘤图谱计划 Relationship between
11、Tumor Enhancement,Edema,IDH1 Mutational Status,MGMTPromoter Methylation, and Survival in Glioblastoma All IDH1 mutant tumors were non-contrast enhancing tumor positive, and most were located in the frontal lobe. J.A. Carrillo et al, AJNR ,2012 中国脑胶质瘤图谱计划 Detecting Isocitrate Dehydrogenase Gene Mutat
12、ions in Oligodendroglial Tumors Using Diffusion Tensor Imaging Metrics and Their Correlations With Proliferation and Microvascular Density FAADC IDH1(-) IDH1(+) Ji Xiong et al, Journal MRI ,2015 This study demonstrated that the MaxFA and MinADC are useful DTI parameters for differentiating Oligodend
13、roglial Tumors with and without IDH mutations. 中国脑胶质瘤图谱计划 Can Diffusion Tensor Imaging Noninvasively Detect IDH1 Gene Mutations in Astrogliomas? A Retrospective Study of 112 Cases This study demonstrates that DTI metrics have potential ability to distinguish astrogliomas with IDH1 mutation from thos
14、e without mutation. FAADC IDH1(-) IDH1(+) W.L. Tan et al, AJNR ,2014 中国脑胶质瘤图谱计划 Non-invasive detection of 2-hydroxyglutarate and other metabolites in IDH1 mutant glioma patients using magnetic resonance spectroscopy Water-suppressed proton (1H) MRS provides a non- invasive measure of 2-HG in gliomas
15、, and may serve as a potential biomarker for patients with IDH1 mutant brain tumors. IDH1mutantWild-type Whitney et al, J Neurooncol ,2013 中国脑胶质瘤图谱计划 EGFR 1、EGFR扩增和EGFR-突变的GBM普遍出现在左颞极延伸到左岛 叶区域3 。 2、EGFR过表达的GBM对比增强体积更大10 但与PTEN，10号染色 体单倍体或多倍体的GBM相比并没有明显的差异3 。 3、EGFR通过表达EGFR-促进胶质母细胞瘤微血管形成。目前的 研究只停留在通过
16、顺磁性氧化铁合成的EGFR共轭体检测EGFR受体 水平和通过diTyr-GdDTPA观察EGFR的表达水平11、12 。 中国脑胶质瘤图谱计划 Probabilistic Radiographic Atlas of Glioblastoma Phenotypes Ellingson et al, AJNR , 2013 EGFR amplified and EGFR variant 3- expressing tumors occurred most frequently in the left temporal lobe. 中国脑胶质瘤图谱计划 Targeted signal amplifying enzymes enh
