Conventional MRI features can predict the molecular subtype of adult grade 2-3 intracranial diffuse gliomas

Lasocki, A; Buckland, ME; Drummond, KJ; Wei, H; Xie, J; Christie, M; Neal, A; Gaillard, F

Author(s): Lasocki, A; Buckland, ME; Drummond, KJ; Wei, H; Xie, J; Christie, M; Neal, A; Gaillard, F;
Details: Publication Year 2022-12,Volume 64,Issue #12,Page 2295-2305
Journal Title: Neuroradiology
Publication Type: Research article
Abstract: PURPOSE: Molecular biomarkers are important for classifying intracranial gliomas, prompting research into correlating imaging with genotype ("radiogenomics"). A limitation of the existing radiogenomics literature is the paucity of studies specifically characterizing grade 2-3 gliomas into the three key molecular subtypes. Our study investigated the accuracy of multiple different conventional MRI features for genotype prediction. METHODS: Grade 2-3 gliomas diagnosed between 2007 and 2013 were identified. Two neuroradiologists independently assessed nine conventional MRI features. Features with better inter-observer agreement (kappa >/= 0.6) proceeded to consensus assessment. MRI features were correlated with genotype, classified as IDH-mutant and 1p/19q-codeleted (IDH(mut)/1p19q(codel)), IDH-mutant and 1p/19q-intact (IDH(mut)/1p19q(int)), or IDH-wildtype (IDH(wt)). For IDH(wt) tumors, additional molecular markers of glioblastoma were noted. RESULTS: One hundred nineteen patients were included. T2-FLAIR mismatch (stratified as > 50%, 25-50%, or < 25%) was the most predictive feature across genotypes (p < 0.001). All 30 tumors with > 50% mismatch were IDH(mut)/1p19q(int), and all seven with 25-50% mismatch. Well-defined margins correlated with IDH(mut)/1p19q(int) status on univariate analysis (p < 0.001), but this related to correlation with T2-FLAIR mismatch; there was no longer an association when considering only tumors with < 25% mismatch (p = 0.386). Enhancement (p = 0.001), necrosis (p = 0.002), and hemorrhage (p = 0.027) correlated with IDH(wt) status (especially "molecular glioblastoma"). Calcification correlated with IDH(mut)/1p19q(codel) status (p = 0.003). A simple, step-wise algorithm incorporating these features, when present, correctly predicted genotype with a positive predictive value 91.8%. CONCLUSION: T2-FLAIR mismatch strongly predicts IDH(mut)/1p19q(int) even with a lower threshold of >/= 25% mismatch and outweighs other features. Secondary features include enhancement, necrosis and hemorrhage (predicting IDH(wt), especially "molecular glioblastoma"), and calcification (predicting IDH(mut)/1p19q(codel)).
Keywords: Adult; Humans; *Brain Neoplasms/diagnostic imaging/genetics/pathology; *Glioblastoma; *Glioma/diagnostic imaging/genetics/pathology; Magnetic Resonance Imaging/methods; Biomarkers; Necrosis; Isocitrate Dehydrogenase/genetics; Mutation; Glioblastoma; Glioma; Mri; Radiogenomics; T2-FLAIR mismatch
Department(s): Cancer Imaging; Biostatistics and Clinical Trials
PubMed ID: 35606654
Publisher's Version: https://doi.org/10.1007/s00234-022-02975-0
Open Access at Publisher's Site: https://doi.org/10.1007/s00234-022-02975-0
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-01-09 06:52:47

Last Modified: 2025-01-09 06:54:51