Diffusion MRI is superior to quantitative T2-FLAIR mismatch in predicting molecular subtypes of human non-enhancing gliomas.

IF 2.4 3区医学 Q2 CLINICAL NEUROLOGY

Neuroradiology Pub Date : 2024-12-01 Epub Date: 2024-10-08 DOI:10.1007/s00234-024-03475-z

Nicholas S Cho, Francesco Sanvito, Viên Lam Le, Sonoko Oshima, Ashley Teraishi, Jingwen Yao, Donatello Telesca, Catalina Raymond, Whitney B Pope, Phioanh L Nghiemphu, Albert Lai, Noriko Salamon, Timothy F Cloughesy, Benjamin M Ellingson

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引用次数: 0

Abstract

Purpose: This study compared the classification performance of normalized apparent diffusion coefficient (nADC) with percentage T2-FLAIR mismatch-volume (%T2FM-volume) for differentiating between IDH-mutant astrocytoma (IDHm-A) and other glioma molecular subtypes.

Methods: A total of 105 non-enhancing gliomas were studied. T2-FLAIR digital subtraction maps were used to identify T2FM and T2-FLAIR non-mismatch (T2FNM) subregions within tumor volumes of interest (VOIs). Median nADC from the whole tumor, T2FM, and T2NFM subregions and %T2FM-volume were obtained. IDHm-A classification analyses using receiver-operating characteristic curves and multiple logistic regression were performed in addition to exploratory survival analyses.

Results: T2FM subregions had significantly higher nADC than T2FNM subregions within IDHm-A with ≥ 25% T2FM-volume (P < 0.0001). IDHm-A with ≥ 25% T2FM-volume demonstrated significantly higher whole tumor nADC compared to IDHm-A with < 25% T2FM-volume (P < 0.0001), and both IDHm-A subgroups demonstrated significantly higher nADC compared to IDH-mutant oligodendroglioma and IDH-wild-type gliomas (P < 0.05). For classification of IDHm-A vs. other gliomas, the area under curve (AUC) of nADC was significantly greater compared to the AUC of %T2FM-volume (P = 0.01, nADC AUC = 0.848, %T2FM-volume AUC = 0.714) along with greater sensitivity. In exploratory survival analyses within IDHm-A, %T2FM-volume was not associated with overall survival (P = 0.2), but there were non-significant trends for nADC (P = 0.07) and tumor volume (P = 0.051).

Conclusion: T2-FLAIR subtraction maps are useful for characterizing IDHm-A imaging characteristics. nADC outperforms %T2FM-volume for classifying IDHm-A amongst non-enhancing gliomas with preserved high specificity and increased sensitivity, which may be related to inherent diffusivity differences regardless of T2FM. In line with previous findings on visual T2FM-sign, quantitative %T2FM-volume may not be prognostic.

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在预测人类非增强型胶质瘤的分子亚型方面，弥散 MRI 优于定量 T2-FLAIR 错配。

目的：本研究比较了归一化表观弥散系数（nADC）和T2-FLAIR错配容积百分比（%T2FM-volume）在区分IDH突变星形细胞瘤（IDHm-A）和其他胶质瘤分子亚型方面的分类性能：方法：共研究了105个非增强型胶质瘤。采用T2-FLAIR数字减影图识别肿瘤感兴趣体积（VOI）内的T2FM和T2-FLAIR非错配（T2FNM）亚区。得出整个肿瘤、T2FM 和 T2NFM 亚区的 nADC 中位数以及 T2FM 体积百分比。除了探索性生存分析外，还使用接收器操作特征曲线和多元逻辑回归进行了 IDHm-A 分类分析：结果：在T2FM容积≥25%的IDHm-A中，T2FM亚区的nADC明显高于T2FNM亚区（P 结论：T2FM亚区的nADC明显高于T2FNM亚区：在对非增强型胶质瘤进行 IDHm-A 分类时，nADC 优于 T2FM 容积百分比，且保留了较高的特异性并提高了灵敏度，这可能与 T2FM 的固有弥散性差异有关。与之前关于视觉 T2FM 信号的研究结果一致，定量 T2FM 容积百分比可能不具有预后性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.