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

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-enhanci...

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Published in:Neuroradiology Vol. 66; no. 12; pp. 2153 - 2163
Main Authors: Cho, Nicholas S., Sanvito, Francesco, Le, Viên Lam, Oshima, Sonoko, Teraishi, Ashley, Yao, Jingwen, Telesca, Donatello, Raymond, Catalina, Pope, Whitney B., Nghiemphu, Phioanh L., Lai, Albert, Salamon, Noriko, Cloughesy, Timothy F., Ellingson, Benjamin M.
Format: diagnostic images research tables/charts Journal Article
Published: Springer Nature Dec2024
Online Access:View this record in EBSCOhost
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      dt: Dec2024
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00234-024-03475-z
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        atl: Diffusion MRI is superior to quantitative T2-FLAIR mismatch in predicting molecular subtypes of human non-enhancing gliomas.
      aug:
        au:
          Cho, Nicholas S.
          Sanvito, Francesco
          Le, Viên Lam
          Oshima, Sonoko
          Teraishi, Ashley
          Yao, Jingwen
          Telesca, Donatello
          Raymond, Catalina
          Pope, Whitney B.
          Nghiemphu, Phioanh L.
          Lai, Albert
          Salamon, Noriko
          Cloughesy, Timothy F.
          Ellingson, Benjamin M.
        affil: Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
      sug:
        subj:
          Magnetic Resonance Imaging Methods
          Subtraction Technique
          Glioma Diagnosis
          Glioma Classification
          Mutation
          Molecular Imaging
          Sensitivity and Specificity Evaluation
          Funding Source
          Human
          Exploratory Research
          Survival Analysis
          ROC Curve
          Multiple Logistic Regression
          Overall Survival
          Tumor Burden
          Paired T-Tests
          Repeated Measures
          Analysis of Variance
          Post Hoc Analysis
          Unpaired T-Tests
          Log-Rank Test
          Univariate Statistics
          Multivariate Analysis
          Cox Proportional Hazards Model
          Data Analysis Software
          Descriptive Statistics
      ab: 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.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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