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Oligodendroglioma, IDH Mutant and 1p/19q Codeleted
Kelly A. Dahlstrom, DO; Karen L. Salzman, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Oligodendroglioma (oligo)
            • Definitions

              • Diffusely infiltrating, slowly growing, cortical/subcortical tumor
                • Requires IDH1 or IDH2 mutation and 1p/19q codeletion
                • Oligo-like tumors lacking diagnostic mutations or in absence of testing capabilities are termed oligo not otherwise specified (NOS)

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Lee MK et al: Advanced imaging parameters improve the prediction of diffuse lower-grade gliomas subtype, IDH mutant with no 1p19q codeletion: added value to the T2/FLAIR mismatch sign. Eur Radiol. 30(2):844-54, 2020
                                            2. Batchala PP et al: Neuroimaging-based classification algorithm for predicting 1p/19q-codeletion status in IDH-mutant lower grade gliomas. AJNR Am J Neuroradiol. 40(3):426-32, 2019
                                            3. van den Bent MJ et al: Grade II and III oligodendroglioma and astrocytoma. Neurol Clin. 36(3):467-84, 2018
                                            4. Johnson DR et al: Genetically defined oligodendroglioma is characterized by indistinct tumor borders at MRI. AJNR Am J Neuroradiol. 38(4):678-84, 2017
                                            5. Johnson DR et al: 2016 Updates to the WHO Brain Tumor Classification System: what the radiologist needs to know. Radiographics. 37(7):2164-80, 2017
                                            6. Lin Y et al: IDH mutant and 1p/19q co-deleted oligodendrogliomas: tumor grade stratification using diffusion-, susceptibility-, and perfusion-weighted MRI. Neuroradiology. 59(6):555-62, 2017
                                            7. Patel SH et al: T2-FLAIR Mismatch, an Imaging Biomarker for IDH and 1p/19q Status in Lower Grade Gliomas: A TCGA/TCIA Project. Clin Cancer Res. ePub, 2017
                                            8. Louis DN et al: The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 131(6):803-20, 2016
                                            9. Ogura R et al: Immunohistochemical profiles of IDH1, MGMT and P53: Practical significance for prognostication of patients with diffuse gliomas. Neuropathology. ePub, 2015
                                            10. Reuss DE et al: ATRX and IDH1-R132H immunohistochemistry with subsequent copy number analysis and IDH sequencing as a basis for an "integrated" diagnostic approach for adult astrocytoma, oligodendroglioma and glioblastoma. Acta Neuropathol. 129(1):133-46, 2015
                                            11. Sahm F et al: Farewell to oligoastrocytoma: in situ molecular genetics favor classification as either oligodendroglioma or astrocytoma. Acta Neuropathol. 128(4):551-9, 2014
                                            12. Chawla S et al: Differentiation between oligodendroglioma genotypes using dynamic susceptibility contrast perfusion-weighted imaging and proton MR spectroscopy. AJNR Am J Neuroradiol. 34(8):1542-9, 2013
                                            13. Jia Z et al: Low-grade and anaplastic oligodendrogliomas: differences in tumour microvascular permeability evaluated with dynamic contrast-enhanced magnetic resonance imaging. J Clin Neurosci. 20(8):1110-3, 2013
                                            14. Kesari S et al: Phase II study of protracted daily temozolomide for low-grade gliomas in adults. Clin Cancer Res. 15(1):330-7, 2009
                                            15. Sepulveda Sanchez JM et al: Classification of oligodendroglial tumors based on histopathology criteria is a significant predictor of survival--clinical, radiological and pathologic long-term follow-up analysis. Clin Neuropathol. 28(1):11-20, 2009
                                            16. Bondy ML et al: Brain tumor epidemiology: consensus from the Brain Tumor Epidemiology Consortium. Cancer. 113(7 Suppl):1953-68, 2008
                                            17. Cairncross G et al: Gliomas with 1p/19q codeletion: a.k.a. oligodendroglioma. Cancer J. 14(6):352-7, 2008
                                            18. Flannery T et al: Familial occurrence of oligodendroglial tumours. Br J Neurosurg. 22(3):436-8, 2008
                                            19. Louis DN et al: WHO Classification of Tumours of the Central Nervous System: Oligodendroglioma. Lyon: IARC Press. 54-59, 2007
                                            20. Spampinato MV et al: Cerebral blood volume measurements and proton MR spectroscopy in grading of oligodendroglial tumors. AJR Am J Roentgenol. 188(1):204-12, 2007
                                            21. Maia AC Jr et al: MR cerebral blood volume maps correlated with vascular endothelial growth factor expression and tumor grade in nonenhancing gliomas. AJNR Am J Neuroradiol. 26(4):777-83, 2005
                                            22. Xu M et al: Comparison of magnetic resonance spectroscopy and perfusion-weighted imaging in presurgical grading of oligodendroglial tumors. Neurosurgery. 56(5):919-26; discussion 919-26, 2005
                                            23. Azzarelli B et al: Immunolocalization of the oligodendrocyte transcription factor 1 (Olig1) in brain tumors. J Neuropathol Exp Neurol. 63(2):170-9, 2004
                                            24. Lev MH et al: Glial tumor grading and outcome prediction using dynamic spin-echo MR susceptibility mapping compared with conventional contrast-enhanced MR: confounding effect of elevated rCBV of oligodendrogliomas [corrected]. AJNR Am J Neuroradiol. 25(2):214-21, 2004
                                            25. Perry JR: Oligodendrogliomas: clinical and genetic correlations. Curr Opin Neurol. 14(6): 705-10, 2001
                                            26. Derlon JM et al: Non-invasive grading of oligodendrogliomas: correlation between in vivo metabolic pattern and histopathology. Eur J Nucl Med. 27(7):778-87, 2000
                                            27. Prayson RA et al: Clinicopathologic study of forty-four histologically pure supratentorial oligodendrogliomas. Ann Diagn Pathol. 4(4):218-27, 2000
                                            28. Caseiras GB et al: Relative cerebral blood volume measurements of low-grade gliomas predict patient outcome in a multi-institution setting. Eur J Radiol.
                                            29. Schomas DA et al: Intracranial Low-Grade Gliomas in Adults: 30-Year Experience With Long-term Follow-up at Mayo Clinic. Neuro Oncol.
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Oligodendroglioma (oligo)
                                                      • Definitions

                                                        • Diffusely infiltrating, slowly growing, cortical/subcortical tumor
                                                          • Requires IDH1 or IDH2 mutation and 1p/19q codeletion
                                                          • Oligo-like tumors lacking diagnostic mutations or in absence of testing capabilities are termed oligo not otherwise specified (NOS)

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Nuclear Medicine Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Lee MK et al: Advanced imaging parameters improve the prediction of diffuse lower-grade gliomas subtype, IDH mutant with no 1p19q codeletion: added value to the T2/FLAIR mismatch sign. Eur Radiol. 30(2):844-54, 2020
                                                                                      2. Batchala PP et al: Neuroimaging-based classification algorithm for predicting 1p/19q-codeletion status in IDH-mutant lower grade gliomas. AJNR Am J Neuroradiol. 40(3):426-32, 2019
                                                                                      3. van den Bent MJ et al: Grade II and III oligodendroglioma and astrocytoma. Neurol Clin. 36(3):467-84, 2018
                                                                                      4. Johnson DR et al: Genetically defined oligodendroglioma is characterized by indistinct tumor borders at MRI. AJNR Am J Neuroradiol. 38(4):678-84, 2017
                                                                                      5. Johnson DR et al: 2016 Updates to the WHO Brain Tumor Classification System: what the radiologist needs to know. Radiographics. 37(7):2164-80, 2017
                                                                                      6. Lin Y et al: IDH mutant and 1p/19q co-deleted oligodendrogliomas: tumor grade stratification using diffusion-, susceptibility-, and perfusion-weighted MRI. Neuroradiology. 59(6):555-62, 2017
                                                                                      7. Patel SH et al: T2-FLAIR Mismatch, an Imaging Biomarker for IDH and 1p/19q Status in Lower Grade Gliomas: A TCGA/TCIA Project. Clin Cancer Res. ePub, 2017
                                                                                      8. Louis DN et al: The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 131(6):803-20, 2016
                                                                                      9. Ogura R et al: Immunohistochemical profiles of IDH1, MGMT and P53: Practical significance for prognostication of patients with diffuse gliomas. Neuropathology. ePub, 2015
                                                                                      10. Reuss DE et al: ATRX and IDH1-R132H immunohistochemistry with subsequent copy number analysis and IDH sequencing as a basis for an "integrated" diagnostic approach for adult astrocytoma, oligodendroglioma and glioblastoma. Acta Neuropathol. 129(1):133-46, 2015
                                                                                      11. Sahm F et al: Farewell to oligoastrocytoma: in situ molecular genetics favor classification as either oligodendroglioma or astrocytoma. Acta Neuropathol. 128(4):551-9, 2014
                                                                                      12. Chawla S et al: Differentiation between oligodendroglioma genotypes using dynamic susceptibility contrast perfusion-weighted imaging and proton MR spectroscopy. AJNR Am J Neuroradiol. 34(8):1542-9, 2013
                                                                                      13. Jia Z et al: Low-grade and anaplastic oligodendrogliomas: differences in tumour microvascular permeability evaluated with dynamic contrast-enhanced magnetic resonance imaging. J Clin Neurosci. 20(8):1110-3, 2013
                                                                                      14. Kesari S et al: Phase II study of protracted daily temozolomide for low-grade gliomas in adults. Clin Cancer Res. 15(1):330-7, 2009
                                                                                      15. Sepulveda Sanchez JM et al: Classification of oligodendroglial tumors based on histopathology criteria is a significant predictor of survival--clinical, radiological and pathologic long-term follow-up analysis. Clin Neuropathol. 28(1):11-20, 2009
                                                                                      16. Bondy ML et al: Brain tumor epidemiology: consensus from the Brain Tumor Epidemiology Consortium. Cancer. 113(7 Suppl):1953-68, 2008
                                                                                      17. Cairncross G et al: Gliomas with 1p/19q codeletion: a.k.a. oligodendroglioma. Cancer J. 14(6):352-7, 2008
                                                                                      18. Flannery T et al: Familial occurrence of oligodendroglial tumours. Br J Neurosurg. 22(3):436-8, 2008
                                                                                      19. Louis DN et al: WHO Classification of Tumours of the Central Nervous System: Oligodendroglioma. Lyon: IARC Press. 54-59, 2007
                                                                                      20. Spampinato MV et al: Cerebral blood volume measurements and proton MR spectroscopy in grading of oligodendroglial tumors. AJR Am J Roentgenol. 188(1):204-12, 2007
                                                                                      21. Maia AC Jr et al: MR cerebral blood volume maps correlated with vascular endothelial growth factor expression and tumor grade in nonenhancing gliomas. AJNR Am J Neuroradiol. 26(4):777-83, 2005
                                                                                      22. Xu M et al: Comparison of magnetic resonance spectroscopy and perfusion-weighted imaging in presurgical grading of oligodendroglial tumors. Neurosurgery. 56(5):919-26; discussion 919-26, 2005
                                                                                      23. Azzarelli B et al: Immunolocalization of the oligodendrocyte transcription factor 1 (Olig1) in brain tumors. J Neuropathol Exp Neurol. 63(2):170-9, 2004
                                                                                      24. Lev MH et al: Glial tumor grading and outcome prediction using dynamic spin-echo MR susceptibility mapping compared with conventional contrast-enhanced MR: confounding effect of elevated rCBV of oligodendrogliomas [corrected]. AJNR Am J Neuroradiol. 25(2):214-21, 2004
                                                                                      25. Perry JR: Oligodendrogliomas: clinical and genetic correlations. Curr Opin Neurol. 14(6): 705-10, 2001
                                                                                      26. Derlon JM et al: Non-invasive grading of oligodendrogliomas: correlation between in vivo metabolic pattern and histopathology. Eur J Nucl Med. 27(7):778-87, 2000
                                                                                      27. Prayson RA et al: Clinicopathologic study of forty-four histologically pure supratentorial oligodendrogliomas. Ann Diagn Pathol. 4(4):218-27, 2000
                                                                                      28. Caseiras GB et al: Relative cerebral blood volume measurements of low-grade gliomas predict patient outcome in a multi-institution setting. Eur J Radiol.
                                                                                      29. Schomas DA et al: Intracranial Low-Grade Gliomas in Adults: 30-Year Experience With Long-term Follow-up at Mayo Clinic. Neuro Oncol.