Individual structural abnormality indexes are associated with molecular, histological and cognitive indicators for glioma patients

Molecular indicators are vital to glioma diagnosis and prognosis. The conventional examination of molecular characteristics requires surgical removal of tumor tissues, therefore could not be fully used in the surgery planning. 52 glioma patients in frontal lobe (mean age 43.2±9.3 years, 34 male) and 117 healthy controls (mean age 32.6±9.8 years, 83 male) participated in the study. All patients underwent neurocognitive test and molecular examinations, including 1p/19q co-deletion, isocitrate dehydrogenase (IDH) mutation, telomerase reverse transcriptase (TERT) promoter mutation and O6-methylguanine-DNA methyltransferase (MGMT) promotor methylation. A series of individual structural abnormality indexes based on preoperative structural MRI were proposed and explored the associations with these clinical indicators. Individual structural abnormality maps displayed that bilateral hippocampus, parahippocampus, insula, putamen and thalamus were constantly affected by glioma regardless of the histological grade, tumor hemisphere and molecular status. Higher grade glioma patients suffered more structural abnormalities, especially in the contralateral hemisphere and non-tumor regions. The molecular indicators, including IDH1 mutation, 1p/19q co-deletion, TERT promoter mutations and MGMT promoter methylation, as well as neurocognitive performance were all significantly correlated to individual structural abnormality indexes. Our proposed individual structural abnormality indexes show great potentials to access the glioma pathological, neurocognitive and molecular indicators, which is very helpful for neurosurgeons to determine the personalized treatment strategies.