Cortical nonenhancing tumor infiltration: a predictive imaging biomarker for IDH-mutant glioma.

IF 3.5 2区医学 Q1 CLINICAL NEUROLOGY

Journal of neurosurgery Pub Date : 2025-04-04 DOI:10.3171/2024.11.JNS242017

Xijie Wang, Haihui Jiang, Mingxiao Li, Xiaokang Zhang, Haoyi Li, Ming Li, Xiaohui Ren, Shouzan Zhang, Siqi Tong, Anzhu Liu, Qingsen Ren, Yong Cui, Song Lin

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引用次数: 0

Abstract

Objective: The aim of this study was to evaluate the cortical nonenhancing tumor infiltration (CONTIN) sign as a predictive imaging biomarker for IDH-mutant gliomas, including diffuse gliomas with and without contrast enhancement.

Methods: Imaging data were collected from patients with diffuse gliomas (grades 2-4) at Beijing Tiantan Hospital (BTH) from January 2019 to December 2021 (training set, n = 526) and from the University of California, San Francisco, preoperative diffuse glioma MRI dataset (UCSF PDGM; validation set, n = 501). Two independent reviewers assessed the CONTIN sign and other radiological features to develop a diagnostic strategy.

Results: Interrater agreement for the CONTIN sign was almost perfect (κ = 0.812). In the BTH cohort, the prevalence of the CONTIN sign in IDH-mutant gliomas was 90.1% overall, with a rate of 92.2% (106/115) in contrast-enhancing gliomas and 88.9% (168/189) in nonenhancing gliomas. In the UCSF PDGM cohort, the overall prevalence was 85.4%, with 81.4% in contrast-enhancing gliomas and 88.3% in nonenhancing gliomas. In contrast-enhancing gliomas, the CONTIN sign significantly improved sensitivity compared with the T2-FLAIR mismatch (T2FMM) sign, with an increase from 14.8% to 92.2% in the BTH cohort and from 23.3% to 81.4% in the UCSF PDGM cohort. Additionally, the CONTIN sign had a high specificity (82.8% in the BTH cohort, 87.4% in the UCSF PDGM cohort) and negative predictive value (94.6% in the BTH cohort, 97.6% in the UCSF PDGM cohort). By integrating the CONTIN sign with T2FMM, contrast enhancement, age at diagnosis, and other features, a reliable diagnostic protocol for IDH-mutant gliomas was established.

Conclusions: The CONTIN sign was a robust imaging biomarker for identifying IDH mutation status in diffuse glioma, particularly for those with contrast enhancement. Preoperative knowledge of IDH mutation status can enhance patient counseling and inform treatment decision-making.

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皮质非增强性肿瘤浸润：idh突变胶质瘤的预测性成像生物标志物。

目的：本研究的目的是评估皮质非增强肿瘤浸润（CONTIN）标志作为idh突变胶质瘤的预测成像生物标志物，包括具有和不具有对比增强的弥漫性胶质瘤。方法：收集2019年1月至2021年12月北京天田医院（BTH）弥漫性胶质瘤（2-4级）患者的影像学数据（训练集，n = 526），以及来自加州大学旧金山分校术前弥漫性胶质瘤MRI数据集(UCSF PDGM；验证集，n = 501)。两名独立审查员评估了CONTIN征象和其他放射学特征，以制定诊断策略。结果：CONTIN标志的判读一致性几乎完全（κ = 0.812）。在BTH队列中，idh突变胶质瘤中CONTIN征象的总体发生率为90.1%，对比增强胶质瘤为92.2%(106/115)，非增强胶质瘤为88.9%（168/189）。在UCSF PDGM队列中，总体患病率为85.4%，其中对比增强胶质瘤为81.4%，非增强胶质瘤为88.3%。在对比增强胶质瘤中，与T2-FLAIR不匹配（T2FMM）体征相比，CONTIN标志显著提高了敏感性，在BTH队列中从14.8%增加到92.2%，在UCSF PDGM队列中从23.3%增加到81.4%。此外，CONTIN信号具有高特异性（BTH组82.8%，UCSF PDGM组87.4%）和阴性预测值（BTH组94.6%，UCSF PDGM组97.6%）。通过将CONTIN征象与T2FMM、对比增强、诊断年龄等特征相结合，建立了idh突变型胶质瘤的可靠诊断方案。结论：CONTIN标志是鉴别弥漫性胶质瘤中IDH突变状态的一个强大的成像生物标志物，特别是对于那些有对比增强的患者。术前了解IDH突变状态可以加强患者咨询，为治疗决策提供信息。

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

Journal of neurosurgery 医学-临床神经学

CiteScore

7.20

自引率

7.30%

发文量

1003

审稿时长

1 months

期刊介绍： The Journal of Neurosurgery, Journal of Neurosurgery: Spine, Journal of Neurosurgery: Pediatrics, and Neurosurgical Focus are devoted to the publication of original works relating primarily to neurosurgery, including studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology. The Editors and Editorial Boards encourage submission of clinical and laboratory studies. Other manuscripts accepted for review include technical notes on instruments or equipment that are innovative or useful to clinicians and researchers in the field of neuroscience; papers describing unusual cases; manuscripts on historical persons or events related to neurosurgery; and in Neurosurgical Focus, occasional reviews. Letters to the Editor commenting on articles recently published in the Journal of Neurosurgery, Journal of Neurosurgery: Spine, and Journal of Neurosurgery: Pediatrics are welcome.