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Early-detection demo · Brain · CNS Tumor

IDH-mutant glioma WHO CNS5 grade 3 with imminent progression

T2 / FLAIR-hyperintense, mildly enhancing left frontal mass with mass effect — IDH-mutant astrocytoma WHO CNS5 grade 3.

Patient: Diego · 38 · 6-week headache + new seizureModality: MRIRisk: high · 79/100
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01

Risk profile

What OCTON knew before the scan
Risk
79
high
Tier
high
Worsening dawn headache + new focal seizure last week. No prior neurologic history. MRI brain ordered urgently.
Contributing factors
  • New focal seizure+24
  • Persistent headache > 4 weeks+18
  • Cognitive change+10
  • Mass effect on imaging+14
  • Age 38 (peak IDH-mut window)+8
  • No prior radiation / NF1+0
Narrative

New seizure + persistent headache in a young adult with a T2/FLAIR-hyperintense lesion is pathognomonic for IDH-mutant glioma. Maximum-safe resection + adjuvant therapy yields meaningful long-term survival.

02

Scan + AI report

What MRI found · Multi-sequence MRI brain (T1+C, T2, FLAIR, DWI, MRS)
MRI · DEMO
WHO CNS5 Grade 3 · IDH-mut
OCTON · scanning · live
conf 0.85
OCTON Impression · 86% confidence

5.2 × 4.1 cm T2 / FLAIR-hyperintense mass in the left frontal lobe with patchy heterogeneous enhancement, mass effect (5 mm midline shift), and elevated Cho/NAA on MR-spectroscopy. Pattern consistent with IDH-mutant astrocytoma, WHO CNS5 grade 3.

Findings
  • Left frontal T2/FLAIR-hyperintense mass · 5.2 cm · Left frontal lobe52 mm
  • Patchy heterogeneous enhancement on T1+C · Mass
  • 5 mm midline shift · Frontal lobe
  • Elevated Cho/NAA on MRS · Mass
Differential diagnosis
  • IDH-mut astrocytoma WHO grade 355%
  • Oligodendroglioma 1p/19q codeletion20%
  • Glioblastoma IDH-WT15%
  • Tumefactive demyelinating lesion6%
  • Brain abscess4%
Recommended actions
  • ▸Urgent neurosurgical referral — maximum-safe resection + intraoperative pathology
  • ▸Molecular profiling (IDH1/2, MGMT, ATRX, 1p/19q, CDKN2A/B)
  • ▸Multidisciplinary neuro-oncology tumor board
  • ▸Adjuvant temozolomide ± radiation per WHO CNS5 stratification
Caveats
  • Imaging features overlap; molecular classification is mandatory.
  • IDH-mut gliomas have substantially better prognosis than IDH-WT.
03

360° Preventative plan

Drugs · surveillance · diet · exercise · lifestyle — generated for this case
Clinical anchors
Drugs · labs · imaging · surveillance
Medical
MGMT + IDH + 1p/19q profiling
FrequencyOnce at diagnosis
Startsage 18
WHO CNS5 2021
Monitoring
MRI brain (multi-sequence)
FrequencyPre-op + every 3 mo Y1, q6 mo Y2+
Startsage 18
NCCN CNS v2.2025
Monitoring
Neuro-oncology multi-D follow-up
FrequencyEvery 3 months Y1
Startsage 18
EANO Glioma 2021
04

What changed

The early-detection win

A 38-year-old with a new seizure and 6-week headache — multi-sequence MRI + MR spectroscopy + molecular profiling routes him to a substantially better-prognosis IDH-mut glioma pathway.

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