ABSTRAK
Latar belakang: Glioma merupakan tumor otak ganas yang berasal dari sel glial dan mencakup sekitar 77% tumor otak primer ganas dengan angka morbiditas dan mortalitas tinggi. Diagnosis umumnya bergantung pada pemeriksaan histopatologi yang bersifat invasif, sedangkan MRI menawarkan metode non-invasif. Sistem VASARI menyediakan cara standar untuk menilai karakteristik tumor. Penanda molekuler seperti mutasi IDH, metilasi MGMT, dan indeks proliferasi Ki-67 penting untuk prognosis. Penelitian ini bertujuan menilai hubungan antara fitur VASARI pada MRI kepala dengan penanda molekuler tersebut pada pasien glioma.
Tujuan: Menentukan hubungan antara distribusi lesi glioma berdasarkan fitur VASARI dengan status mutasi IDH, metilasi MGMT, dan indeks proliferasi Ki-67 pada pasien di RSUP Dr. Sardjito Yogyakarta tahun 2017–2022.
Metode: Studi observasional potong lintang menggunakan data retrospektif 107 pasien glioma dengan hasil MRI praoperatif dan biopsi. Fitur VASARI yang dianalisis meliputi lokasi tumor (F1), sisi lesi (F2), keterlibatan area eloquent (F3), rasio T1/FLAIR (F10), dan satelit (F24). Analisis statistik menggunakan uji chi-square, t-test, dan ANOVA dengan mempertimbangkan derajat glioma sebagai variabel perancu.
Hasil: Rata-rata usia pasien 45,9 tahun; 56% laki-laki dan 74% menderita glioma derajat tinggi. Ditemukan hubungan bermakna antara status mutasi IDH dengan lokasi tumor (F1, p<0 p=0,012), p=0,009).>
Kesimpulan: Dua fitur VASARI berhubungan bermakna dengan status mutasi IDH, satu fitur berhubungan dengan indeks Ki-67, sedangkan tidak ada hubungan dengan metilasi MGMT.
Kata kunci: Glioma, MRI, VASARI, mutasi IDH, metilasi MGMT, indeks proliferasi Ki-67.
ABSTRACT
Background: Gliomas are malignant brain tumors originating from glial cells, comprising 77% of malignant primary brain tumors with high morbidity and mortality. Diagnosis commonly depends on invasive histopathology, while MRI offers a non-invasive alternative. The VASARI system provides standardized MRI-based tumor characterization. Molecular markers such as IDH mutation, MGMT methylation, and Ki-67 index are essential for prognosis. This study explores the association between MRI-based VASARI features and these molecular markers in glioma patients.
Objective: To determine the association between VASARI-assessed glioma lesion distribution and IDH mutation, MGMT methylation, and Ki-67 index in patients at RSUP Dr. Sardjito Yogyakarta (2017–2022).
Methods: An observational cross-sectional study using retrospective data from 107 glioma patients with pre-surgical MRI and biopsy results. VASARI features analyzed were tumor location (F1), lesion side (F2), eloquent area involvement (F3), T1/FLAIR ratio (F10), and satellites (F24). Associations were analyzed using chi-square, t-test, and ANOVA, considering glioma grade as a confounder.
Results: Mean patient age was 45.9 years; 56% were male, and 74% had high-grade gliomas. Significant associations were found between IDH mutation with tumor location (F1, p<0 p=0.012), p=0.009).>
Conclusion: Two VASARI features were significantly associated with IDH mutation status, one with Ki-67 index, while none correlated with MGMT methylation.
Keywords: Glioma, MRI, VASARI, IDH mutation, MGMT methylation, Ki-67 index.
Kata Kunci : Glioma, MRI, VASARI, IDH mutation, MGMT methylation, Ki-67 Proliferation Index.
