Fifty‐three consecutive patients with histopathologically validated gliomas (44 high‐grade gliomas and nine low‐grade gliomas) (33 men and 20 women, aged 46.547 ± 13.580, [range 18‐72] years) who underwent standard MRI for presurgical planning at our hospital between September 2013 and September 2018 were included in this retrospective cross‐sectional study. Our study was approved by our institutional review board, and the requirement of written informed consent was waived. The inclusion criteria were as follows: (a) adults with histopathology verified primary gliomas who had no history of central nervous system malignancy; (b) underwent MGMT promoter methylation status testing; (c) underwent preoperative MRI including routine diagnostic protocol; (d) MR images were obtained without artifacts that affect image observation and post‐processing; and (e) had not undergone radiotherapy, chemotherapy, or other treatment prior to MRI acquisition and surgery. The gender, age, histopathologic types (GBM, diffusely infiltrating astrocytomas [including NOS], oligodendroglioma [including NOS], diffuse midline glioma, and other astrocytomas), and tumor grade (high and low) were considered as clinical factors associated with MGMT status. According to the WHO guidelines, gliomas are graded I‐IV using the following histological criteria: cytological atypia, mitotic activity, cellularity, microvascular proliferation, and/or necrosis. Gliomas graded I and II were classified as low‐grade gliomas, whereas gliomas graded III and IV were classified as high‐grade gliomas. 10

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