Diffusion and perfusion MRI may predict EGFR amplification and the TERT promoter mutation status of IDH-wildtype lower-grade gliomas.

Objectives: Epidermal growth factor receptor (EGFR) amplification and telomerase reverse transcriptase promoter (TERTp) mutation status of isocitrate dehydrogenase-wildtype (IDHwt) lower-grade gliomas (LGGs; grade II/III) are crucial for identifying IDHwt LGG with an aggressive clinical course. The...

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Publicado en:European Radiology Vol. 30; no. 12; pp. 6475 - 6485
Autores principales: Park, Yae Won, Ahn, Sung Soo, Park, Chae Jung, Han, Kyunghwa, Kim, Eui Hyun, Kang, Seok-Gu, Chang, Jong Hee, Kim, Se Hoon, Lee, Seung-Koo
Formato: Journal Article
Publicado: Springer Nature Dec2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2020
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      pub: Springer Nature
      place: New York, New York
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        atl: Diffusion and perfusion MRI may predict EGFR amplification and the TERT promoter mutation status of IDH-wildtype lower-grade gliomas.
      aug:
        au:
          Park, Yae Won
          Ahn, Sung Soo
          Park, Chae Jung
          Han, Kyunghwa
          Kim, Eui Hyun
          Kang, Seok-Gu
          Chang, Jong Hee
          Kim, Se Hoon
          Lee, Seung-Koo
        affil: Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, South Korea
      sug:
        subj:
          Glioma
          Brain Neoplasms
          Magnetic Resonance Imaging Methods
          Transferases
          Magnetic Resonance Angiography Methods
          Mutation
          Oxidoreductases
          Brain Neoplasms Pathology
          Male
          Receptors, Cell Surface
          Adult
          Genes
          Reproducibility of Results
          Pilot Studies
          Female
          Glioma Pathology
          Middle Age
          Sensitivity and Specificity
          Retrospective Design
          Clinical Assessment Tools
          Scales
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Objectives: Epidermal growth factor receptor (EGFR) amplification and telomerase reverse transcriptase promoter (TERTp) mutation status of isocitrate dehydrogenase-wildtype (IDHwt) lower-grade gliomas (LGGs; grade II/III) are crucial for identifying IDHwt LGG with an aggressive clinical course. The purpose of this study was to assess whether parameters from diffusion tensor imaging, dynamic susceptibility contrast (DSC), and diffusion tensor imaging, dynamic contrast-enhanced imaging can predict the EGFR amplification and TERTp mutation status of IDHwt LGGs.Methods: A total of 49 patients with IDHwt LGGs with either known EGFR amplification (39 non-amplified, 10 amplified) or TERTp mutation (19 wildtype, 21 mutant) statuses underwent MRI. The mean ADC, fractional anisotropy (FA), normalized cerebral blood volume (nCBV), normalized cerebral blood flow (nCBF), volume transfer constant (Ktrans), rate transfer coefficient (Kep), extravascular extracellular volume fraction (Ve), and plasma volume fraction (Vp) values were assessed. Univariate and multivariate logistic regression models were constructed.Results: EGFR-amplified tumors showed lower mean ADC values than EGFR-non-amplified tumors (p = 0.019). Mean ADC was an independent predictor of EGFR amplification, with an AUC of 0.75. TERTp mutant tumors showed higher mean nCBV (p = 0.020), higher mean nCBF (p = 0.017), and higher mean Vp (p = 0.002) than TERTp wildtype tumors. With multivariate logistic regression, mean Vp was the independent predictor of TERTp mutation status, with an AUC of 0.85.Conclusion: This exploratory pilot study shows that lower ADC values may be useful for prediction of EGFR amplification, whereas higher Vp values may be useful for prediction of the TERTp mutation status of IDHwt LGGs.Key Points: • EGFR amplification and TERTp mutation are key molecular markers that predict an aggressive clinical course of IDHwt LGGs. • EGFR-amplified tumors showed lower ADC values than EGFR-non-amplified tumors, suggesting higher cellularity. • TERTp mutant tumors showed a higher plasma volume fraction than TERTp wildtype tumors, suggesting higher vascular proliferation and tumor angiogenesis.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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