Assess the contribution of preoperative MRI data in improving grading of adult astrocytomas reclassified according to the WHO 2016 and cIMPACT-NOW update 3. Retrospective unicentric cohort study of 679 adult patients treated for newly diagnosed diffuse astrocytic and oligodendroglial tumors (January 2006–December 2016). We first systematically compared radiological (contrast enhancement present [CE+] vs. absent [CE−]) and histopathological findings (microvascular proliferation present [MPV+] vs. absent [MPV−]) to validate whether this comparing step of neoangiogenesis represents an efficient method to appreciate the representativity of the tumoral sampling. We focused on 629 cases of astrocytomas for radio-histological integrated analyses. In 598 cases (95.1%), neoangiogenesis evaluated by MRI or histology (CE+/MPV+ or CE−/MPV−) was identical. For the CE+/MPV− and CE−/MPV+ groups (23 cases), the radio-histological face-to-face evaluation allowed us to assess that for 13 cases (56.5%) the reason for this discrepancy was an undersampled tumor. We analyzed the group of CE+/MPV− (n = 8) and CE−/MPV+ (n = 2) in verified image-guided tumoral samples. Finally, we identified three new prognostic subgroups for molecular glioblastomas: (1) “non-representative sampling” (n = 9), (2) “Non neoangiogenic glioblastoma at the time of diagnosis, without contrast enhancement and microvascular proliferation” (n = 8), and (3) “contrast enhancing glioblastoma but without microvascular proliferation in a representative sample” (n = 4). Neoangiogenesis processes should be assessed to improve the prognosis accuracy of the current integrated diagnosis. We suggest adding imaging analyses during the neuropathological analysis of astrocytomas in adults.

中文翻译：

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将 MRI 数据添加到 WHO 2016 和 cIMPACT-NOW 更新对成人弥漫性星形细胞肿瘤的预后相关性。致力于扩大 MRI 数据在胶质瘤综合诊断中的应用

评估术前 MRI 数据对改善根据 WHO 2016 和 cIMPACT-NOW 更新 3 重新分类的成人星形细胞瘤分级的贡献。对 679 名新诊断的弥漫性星形细胞瘤和少突胶质细胞瘤接受治疗的成年患者进行的回顾性单中心队列研究（2006 年 1 月至 2016 年 12 月） . 我们首先系统地比较了放射学（存在对比增强 [CE+] 与不存在 [CE-]）和组织病理学发现（存在微血管增殖 [MPV+] 与不存在 [MPV-]），以验证新血管生成的这种比较步骤是否代表一种有效的方法了解肿瘤取样的代表性。我们专注于 629 例星形细胞瘤进行放射组织学综合分析。在 598 例 (95.1%) 中，通过 MRI 或组织学 (CE+/MPV+ 或 CE-/MPV-) 评估的新血管生成是相同的。对于 CE+/MPV- 和 CE-/MPV+ 组（23 例），放射组织学面对面评估使我们能够评估 13 例（56.5%）这种差异的原因是肿瘤样本不足。我们在经过验证的图像引导肿瘤样本中分析了 CE+/MPV- (n = 8) 和 CE-/MPV+ (n = 2) 组。最后，我们确定了分子胶质母细胞瘤的三个新的预后亚组：（1）“非代表性取样”（n = 9），（2）“诊断时非新生血管生成胶质母细胞瘤，没有对比增强和微血管增殖”（n = 8）和（3）“在代表性样本中对比增强胶质母细胞瘤但没有微血管增殖”（n = 4）。应评估新血管生成过程以提高当前综合诊断的预后准确性。