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Open Access 24-05-2022 | Glioblastoma | Diagnostic Neuroradiology

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

Authors: Arian Lasocki, Michael E. Buckland, Katharine J. Drummond, Heng Wei, Jing Xie, Michael Christie, Andrew Neal, Frank Gaillard

Published in: Neuroradiology | Issue 12/2022

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 (κ ≥ 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).

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N Engl J Med 372(26):2481–2498. https://doi.org/10.1056/NEJMoa1402121CrossRefPubMed

Title: Conventional MRI features can predict the molecular subtype of adult grade 2–3 intracranial diffuse gliomas
Authors: Arian Lasocki
Michael E. Buckland
Katharine J. Drummond
Heng Wei
Jing Xie
Michael Christie
Andrew Neal
Frank Gaillard
Publication date: 24-05-2022
Publisher: Springer Berlin Heidelberg
Keywords: Glioblastoma
Glioma
Glioma
Glioblastoma
Glioblastoma
Glioma
Published in: Neuroradiology / Issue 12/2022
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-022-02975-0

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

Abstract

Purpose

Methods

Results

Conclusion

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Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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