MRI-Derived Tumor Growth Velocity Adds Prognostic Information in IDH-Mutant Gliomas

A multicenter retrospective study of 569 adults with grade 2–3 IDH-mutant gliomas found that pretherapeutic tumor growth velocity on serial MRI was independently associated with overall survival. The measure also improved prognostic model fit, with the greatest incremental value reported in astrocytomas.

Study included 569 adults across three French centers.
Higher MRI-derived TGV was associated with shorter overall survival.
Association was replicated in external validation cohorts.
Findings support prognostic refinement, not treatment changes.

Risk assessment for IDH-mutant lower-grade gliomas commonly uses molecular features and postoperative tumor burden, but does not directly account for how quickly a tumor grows. This multicenter retrospective study included 569 adults treated at three French centers: 440 in the development cohort and 129 in external validation cohorts. Investigators calculated pretherapeutic tumor growth velocity (TGV) from serial preoperative MRI and assessed its association with overall survival (OS), adjusting for clinical, molecular, and surgical factors.

Over a median follow-up of 6.8 years, 73 deaths occurred in the development cohort. Each 1-mm/year increase in TGV was associated with shorter OS after adjustment (hazard ratio, 1.046; 95% CI, 1.011–1.083; P=.011). The association was replicated in the external cohorts (hazard ratio, 1.077; 95% CI, 1.005–1.153; P=.035). Results were consistent using log-volume growth and after accounting for CDKN2A/B status. Adding TGV improved model fit, with the greatest reported incremental prognostic value in astrocytomas.

The findings suggest that serial MRI growth measurements may help refine individualized prognostic stratification. However, the study was retrospective, and the reported results establish prognostic association rather than showing that TGV-guided treatment decisions improve outcomes. The abstract does not report a prospective assessment of clinical implementation.

In practice

For adults with grade 2–3 IDH-mutant gliomas, tumor growth velocity derived from serial preoperative MRI was independently associated with overall survival and added prognostic information beyond clinical, molecular, and surgical factors in a retrospective multicenter cohort with external validation. This may support further evaluation of MRI growth measurements in individualized risk stratification, particularly for astrocytomas. The study does not show that using TGV to select treatment improves outcomes, so it does not establish a basis for changing management.

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Source

Neuro-Oncology: Pretherapeutic Tumor Growth Velocity Refines Survival Stratification Beyond Clinical, Molecular, and Surgical Factors in IDH-Mutant Lower-Grade Gliomas ↗

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