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Open Access 29-01-2024 | Oligodendroglioma | Neuro

Differentiating IDH-mutant astrocytomas and 1p19q-codeleted oligodendrogliomas using DSC-PWI: high performance through cerebral blood volume and percentage of signal recovery percentiles

Authors: Albert Pons-Escoda, Alonso Garcia-Ruiz, Pablo Naval-Baudin, Ignacio Martinez-Zalacain, Josep Castell, Angels Camins, Noemi Vidal, Jordi Bruna, Monica Cos, Raquel Perez-Lopez, Laura Oleaga, Esther Warnert, Marion Smits, Carles Majos

Published in: European Radiology

Abstract

Objective

Presurgical differentiation between astrocytomas and oligodendrogliomas remains an unresolved challenge in neuro-oncology. This research aims to provide a comprehensive understanding of each tumor’s DSC-PWI signatures, evaluate the discriminative capacity of cerebral blood volume (CBV) and percentage of signal recovery (PSR) percentile values, and explore the synergy of CBV and PSR combination for pre-surgical differentiation.

Methods

Patients diagnosed with grade 2 and 3 IDH-mutant astrocytomas and IDH-mutant 1p19q-codeleted oligodendrogliomas were retrospectively retrieved (2010–2022). 3D segmentations of each tumor were conducted, and voxel-level CBV and PSR were extracted to compute mean, minimum, maximum, and percentile values. Statistical comparisons were performed using the Mann-Whitney U test and the area under the receiver operating characteristic curve (AUC-ROC). Lastly, the five most discriminative variables were combined for classification with internal cross-validation.

Results

The study enrolled 52 patients (mean age 45-year-old, 28 men): 28 astrocytomas and 24 oligodendrogliomas. Oligodendrogliomas exhibited higher CBV and lower PSR than astrocytomas across all metrics (e.g., mean CBV = 2.05 and 1.55, PSR = 0.68 and 0.81 respectively). The highest AUC-ROCs and the smallest p values originated from CBV and PSR percentiles (e.g., PSRp70 AUC-ROC = 0.84 and p value = 0.0005, CBVp75 AUC-ROC = 0.8 and p value = 0.0006). The mean, minimum, and maximum values yielded lower results. Combining the best five variables (PSRp65, CBVp70, PSRp60, CBVp75, and PSRp40) achieved a mean AUC-ROC of 0.87 for differentiation.

Conclusions

Oligodendrogliomas exhibit higher CBV and lower PSR than astrocytomas, traits that are emphasized when considering percentiles rather than mean or extreme values. The combination of CBV and PSR percentiles results in promising classification outcomes.

Clinical relevance statement

The combination of histogram-derived percentile values of cerebral blood volume and percentage of signal recovery from DSC-PWI enhances the presurgical differentiation between astrocytomas and oligodendrogliomas, suggesting that incorporating these metrics into clinical practice could be beneficial.

Key Points

• The unsupervised selection of percentile values for cerebral blood volume and percentage of signal recovery enhances presurgical differentiation of astrocytomas and oligodendrogliomas.

• Oligodendrogliomas exhibit higher cerebral blood volume and lower percentage of signal recovery than astrocytomas.

• Cerebral blood volume and percentage of signal recovery combined provide a broader perspective on tumor vasculature and yield promising results for this preoperative classification.

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Title: Differentiating IDH-mutant astrocytomas and 1p19q-codeleted oligodendrogliomas using DSC-PWI: high performance through cerebral blood volume and percentage of signal recovery percentiles
Authors: Albert Pons-Escoda
Alonso Garcia-Ruiz
Pablo Naval-Baudin
Ignacio Martinez-Zalacain
Josep Castell
Angels Camins
Noemi Vidal
Jordi Bruna
Monica Cos
Raquel Perez-Lopez
Laura Oleaga
Esther Warnert
Marion Smits
Carles Majos
Publication date: 29-01-2024
Publisher: Springer Berlin Heidelberg
Keywords: Oligodendroglioma
Astrocytoma
Astrocytoma
Astrocytoma
Published in: European Radiology
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-024-10611-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Differentiating IDH-mutant astrocytomas and 1p19q-codeleted oligodendrogliomas using DSC-PWI: high performance through cerebral blood volume and percentage of signal recovery percentiles

Abstract

Objective

Methods

Results

Conclusions

Clinical relevance statement

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Clinical relevance statement

Key Points

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