Magnetic resonance imaging characteristics of glioblastoma multiforme: implications for understanding glioma ontogeny.
Magnetic resonance imaging characteristics of glioblastoma multiforme: implications for understanding glioma ontogeny.
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DOI：
10.1227/neu.0b013e3181f556ab
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发表时间：
2010-11
期刊：
影响因子：
4.8
通讯作者：
Bruce JN
中科院分区：
文献类型：
--
作者：
Bohman LE;Swanson KR;Moore JL;Rockne R;Mandigo C;Hankinson T;Assanah M;Canoll P;Bruce JN
识别神经胶质瘤的起源对于推进这些顽固性肿瘤的治疗具有重要意义。最近的研究提出了在人类神经胶质瘤标本中发现的干状神经胶质瘤细胞的室下区（SVZ）起源的假设。然而，相互矛盾的证据表明，SVZ 样细胞并不是唯一的神经胶质瘤形成细胞，但分布在整个皮层下白质 (SCWM) 的循环祖细胞可能具有这种能力。回顾多形性胶质母细胞瘤 (GBM) 患者的放射学证据，以深入了解胶质瘤个体发育问题。我们通过对 63 名患者的术前增强 T1 加权磁共振图像进行回顾性分析，探讨了首次诊断时 GBM 是否表现出与 SVZ 起源一致的解剖分布模式。然后，我们使用神经胶质瘤生长的计算机模型检查了肿瘤体积、起源点和与脑室的接近程度的关系。在术前成像中，所分析的 GBM 中不到一半具有与心室接触的对比度增强部分。研究发现肿瘤体积与肿瘤对比增强边缘和心室之间的距离之间存在很强的相关性，这表明毗邻心室的肿瘤明显大于那些不毗邻心室的肿瘤。计算机模型模拟的病变验证了我们的假设，即放射学上远离心室的肿瘤不太可能起源于 SVZ，并支持了我们的假设，即随着肿瘤的生长，所有肿瘤的边缘都会靠近心室，无论其起源点如何。这项工作进一步支持了以下假设：GBM 的起源分布在整个白质中，并且不限于 SVZ 区域。
Identifying the origin of gliomas carries important implications for advancing the treatment of these recalcitrant tumors. Recent research promotes the hypothesis of a subventricular zone (SVZ) origin for the stemlike gliomagenic cells identified within human glioma specimens. However, conflicting evidence suggests that SVZ-like cells are not uniquely gliomagenic but this capacity may be shared by cycling progenitors distributed throughout the subcortical white matter (SCWM). To review radiological evidence in glioblastoma multiforme (GBM) patients to provide insight into the question of glioma ontogeny. We explored whether GBMs at first diagnosis demonstrated a pattern of anatomic distribution consistent with origin at the SVZ through retrospective analysis of preoperative contrast-enhanced T1-weighted magnetic resonance images in 63 patients. We then examined the relationship of tumor volume, point of origin, and proximity to the ventricles using a computer model of glioma growth. Fewer than half of the GBMs analyzed had contrast-enhancing portions that contacted the ventricle on preoperative imaging. A strong correlation was found between tumor volume and the distance between the contrast-enhancing edge of the tumor and the ventricle, demonstrating that tumors abutting the ventricle are significantly larger than those that do not. The lesions simulated by the computer model validated our assumption that tumors that are radiographically distant from the ventricles are unlikely to have originated in the SVZ and supported our hypothesis that as they grow, the edges of all tumors will near the ventricles, regardless of their point of origin. This work offers further support for the hypothesis that the origins of GBMs are at sites distributed throughout the white matter and are not limited to the region of the SVZ.