Skip to main content
Erschienen in:

19.07.2023 | Diagnostic Neuroradiology

Association of partial T2-FLAIR mismatch sign and isocitrate dehydrogenase mutation in WHO grade 4 gliomas: results from the ReSPOND consortium

verfasst von: Matthew D. Lee, Sohil H. Patel, Suyash Mohan, Hamed Akbari, Spyridon Bakas, MacLean P. Nasrallah, Evan Calabrese, Jeffrey Rudie, Javier Villanueva-Meyer, Pamela LaMontagne, Daniel S. Marcus, Rivka R. Colen, Carmen Balana, Yoon Seong Choi, Chaitra Badve, Jill S. Barnholtz-Sloan, Andrew E. Sloan, Thomas C. Booth, Joshua D. Palmer, Adam P. Dicker, Adam E. Flanders, Wenyin Shi, Brent Griffith, Laila M. Poisson, Arnab Chakravarti, Abhishek Mahajan, Susan Chang, Daniel Orringer, Christos Davatzikos, Rajan Jain, the ReSPOND Consortium

Erschienen in: Neuroradiology | Ausgabe 9/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose

While the T2-FLAIR mismatch sign is highly specific for isocitrate dehydrogenase (IDH)-mutant, 1p/19q-noncodeleted astrocytomas among lower-grade gliomas, its utility in WHO grade 4 gliomas is not well-studied. We derived the partial T2-FLAIR mismatch sign as an imaging biomarker for IDH mutation in WHO grade 4 gliomas.

Methods

Preoperative MRI scans of adult WHO grade 4 glioma patients (n = 2165) from the multi-institutional ReSPOND (Radiomics Signatures for PrecisiON Diagnostics) consortium were analyzed. Diagnostic performance of the partial T2-FLAIR mismatch sign was evaluated. Subset analyses were performed to assess associations of imaging markers with overall survival (OS).

Results

One hundred twenty-one (5.6%) of 2165 grade 4 gliomas were IDH-mutant. Partial T2-FLAIR mismatch was present in 40 (1.8%) cases, 32 of which were IDH-mutant, yielding 26.4% sensitivity, 99.6% specificity, 80.0% positive predictive value, and 95.8% negative predictive value. Multivariate logistic regression demonstrated IDH mutation was significantly associated with partial T2-FLAIR mismatch (odds ratio [OR] 5.715, 95% CI [1.896, 17.221], p = 0.002), younger age (OR 0.911 [0.895, 0.927], p < 0.001), tumor centered in frontal lobe (OR 3.842, [2.361, 6.251], p < 0.001), absence of multicentricity (OR 0.173, [0.049, 0.612], p = 0.007), and presence of cystic (OR 6.596, [3.023, 14.391], p < 0.001) or non-enhancing solid components (OR 6.069, [3.371, 10.928], p < 0.001). Multivariate Cox analysis demonstrated cystic components (p = 0.024) and non-enhancing solid components (p = 0.003) were associated with longer OS, while older age (p < 0.001), frontal lobe center (p = 0.008), multifocality (p < 0.001), and multicentricity (p < 0.001) were associated with shorter OS.

Conclusion

Partial T2-FLAIR mismatch sign is highly specific for IDH mutation in WHO grade 4 gliomas.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Louis DN, Perry A, Wesseling P et al (2021) The 2021 WHO classification of tumors of the central nervous system: a summary. Neuro Oncol 23(8):1231–1251CrossRefPubMedPubMedCentral Louis DN, Perry A, Wesseling P et al (2021) The 2021 WHO classification of tumors of the central nervous system: a summary. Neuro Oncol 23(8):1231–1251CrossRefPubMedPubMedCentral
2.
3.
Zurück zum Zitat Beiko J, Suki D, Hess KR et al (2014) IDH1 mutant malignant astrocytomas are more amenable to surgical resection and have a survival benefit associated with maximal surgical resection. Neuro Oncol 16(1):81–91CrossRefPubMed Beiko J, Suki D, Hess KR et al (2014) IDH1 mutant malignant astrocytomas are more amenable to surgical resection and have a survival benefit associated with maximal surgical resection. Neuro Oncol 16(1):81–91CrossRefPubMed
4.
Zurück zum Zitat Patel SH, Poisson LM, Brat DJ et al (2017) T2-FLAIR mismatch, an imaging biomarker for IDH and 1p/19q status in lower-grade gliomas: a TCGA/TCIA project. Clin Cancer Res 23(20):6078–6085CrossRefPubMed Patel SH, Poisson LM, Brat DJ et al (2017) T2-FLAIR mismatch, an imaging biomarker for IDH and 1p/19q status in lower-grade gliomas: a TCGA/TCIA project. Clin Cancer Res 23(20):6078–6085CrossRefPubMed
5.
Zurück zum Zitat Broen MPG, Smits M, Wijnenga MMJ et al (2018) The T2-FLAIR mismatch sign as an imaging marker for non-enhancing IDH-mutant, 1p/19q-intact lower-grade glioma: a validation study. Neuro Oncol 20(10):1393–1399CrossRefPubMedPubMedCentral Broen MPG, Smits M, Wijnenga MMJ et al (2018) The T2-FLAIR mismatch sign as an imaging marker for non-enhancing IDH-mutant, 1p/19q-intact lower-grade glioma: a validation study. Neuro Oncol 20(10):1393–1399CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Jain R, Johnson DR, Patel SH et al (2020) “Real world” use of a highly reliable imaging sign: “T2-FLAIR mismatch” for identification of IDH mutant astrocytomas. Neuro Oncol 22(7):936–943CrossRefPubMedPubMedCentral Jain R, Johnson DR, Patel SH et al (2020) “Real world” use of a highly reliable imaging sign: “T2-FLAIR mismatch” for identification of IDH mutant astrocytomas. Neuro Oncol 22(7):936–943CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Do YA, Cho SJ, Choi BS et al (2022) Predictive accuracy of T2-FLAIR mismatch sign for the IDH-mutant, 1p/19q noncodeleted low-grade glioma: an updated systematic review and meta-analysis. Neurooncol Adv 4(1):vdac010PubMedPubMedCentral Do YA, Cho SJ, Choi BS et al (2022) Predictive accuracy of T2-FLAIR mismatch sign for the IDH-mutant, 1p/19q noncodeleted low-grade glioma: an updated systematic review and meta-analysis. Neurooncol Adv 4(1):vdac010PubMedPubMedCentral
8.
Zurück zum Zitat Han Z, Chen Q, Zhang L, et al. (2022) Radiogenomic association between the T2-FLAIR mismatch sign and IDH mutation status in adult patients with lower-grade gliomas: an updated systematic review and meta-analysis. Eur Radiol Han Z, Chen Q, Zhang L, et al. (2022) Radiogenomic association between the T2-FLAIR mismatch sign and IDH mutation status in adult patients with lower-grade gliomas: an updated systematic review and meta-analysis. Eur Radiol
9.
Zurück zum Zitat Foltyn M, Nieto Taborda KN, Neuberger U et al (2020) T2/FLAIR-mismatch sign for noninvasive detection of IDH-mutant 1p/19q non-codeleted gliomas: validity and pathophysiology. Neurooncol Adv 2(1):vdaa004PubMedPubMedCentral Foltyn M, Nieto Taborda KN, Neuberger U et al (2020) T2/FLAIR-mismatch sign for noninvasive detection of IDH-mutant 1p/19q non-codeleted gliomas: validity and pathophysiology. Neurooncol Adv 2(1):vdaa004PubMedPubMedCentral
10.
Zurück zum Zitat Patel SH, Batchala PP, Muttikkal TJE et al (2021) Fluid attenuation in non-contrast-enhancing tumor (nCET): an MRI Marker for Isocitrate Dehydrogenase (IDH) mutation in Glioblastoma. J Neurooncol 152(3):523–531CrossRefPubMed Patel SH, Batchala PP, Muttikkal TJE et al (2021) Fluid attenuation in non-contrast-enhancing tumor (nCET): an MRI Marker for Isocitrate Dehydrogenase (IDH) mutation in Glioblastoma. J Neurooncol 152(3):523–531CrossRefPubMed
11.
Zurück zum Zitat Davatzikos C, Barnholtz-Sloan JS, Bakas S et al (2020) AI-based prognostic imaging biomarkers for precision neuro-oncology: the ReSPOND consortium. Neuro Oncol 22(6):886–888CrossRefPubMedPubMedCentral Davatzikos C, Barnholtz-Sloan JS, Bakas S et al (2020) AI-based prognostic imaging biomarkers for precision neuro-oncology: the ReSPOND consortium. Neuro Oncol 22(6):886–888CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Menze BH, Jakab A, Bauer S et al (2015) The multimodal brain tumor image segmentation benchmark (BRATS). IEEE Trans Med Imaging 34(10):1993–2024CrossRefPubMed Menze BH, Jakab A, Bauer S et al (2015) The multimodal brain tumor image segmentation benchmark (BRATS). IEEE Trans Med Imaging 34(10):1993–2024CrossRefPubMed
14.
Zurück zum Zitat Rohlfing T, Zahr NM, Sullivan EV, Pfefferbaum A (2010) The SRI24 multichannel atlas of normal adult human brain structure. Hum Brain Mapp 31(5):798–819CrossRefPubMed Rohlfing T, Zahr NM, Sullivan EV, Pfefferbaum A (2010) The SRI24 multichannel atlas of normal adult human brain structure. Hum Brain Mapp 31(5):798–819CrossRefPubMed
15.
17.
Zurück zum Zitat Chang K, Bai HX, Zhou H et al (2018) Residual convolutional neural network for the determination of IDH status in low- and high-grade gliomas from MR imaging. Clin Cancer Res 24(5):1073–1081CrossRefPubMed Chang K, Bai HX, Zhou H et al (2018) Residual convolutional neural network for the determination of IDH status in low- and high-grade gliomas from MR imaging. Clin Cancer Res 24(5):1073–1081CrossRefPubMed
18.
Zurück zum Zitat Choi YS, Bae S, Chang JH et al (2021) Fully automated hybrid approach to predict the IDH mutation status of gliomas via deep learning and radiomics. Neuro Oncol 23(2):304–313CrossRefPubMed Choi YS, Bae S, Chang JH et al (2021) Fully automated hybrid approach to predict the IDH mutation status of gliomas via deep learning and radiomics. Neuro Oncol 23(2):304–313CrossRefPubMed
19.
Zurück zum Zitat Jian A, Jang K, Manuguerra M, Liu S, Magnussen J, Di Ieva A (2021) Machine learning for the prediction of molecular markers in glioma on magnetic resonance imaging: a systematic review and meta-analysis. Neurosurgery 89(1):31–44CrossRefPubMed Jian A, Jang K, Manuguerra M, Liu S, Magnussen J, Di Ieva A (2021) Machine learning for the prediction of molecular markers in glioma on magnetic resonance imaging: a systematic review and meta-analysis. Neurosurgery 89(1):31–44CrossRefPubMed
20.
Zurück zum Zitat Calabrese E, Rudie JD, Rauschecker AM et al (2022) Combining radiomics and deep convolutional neural network features from preoperative MRI for predicting clinically relevant genetic biomarkers in glioblastoma. Neurooncol Adv 4(1):vdac060PubMedPubMedCentral Calabrese E, Rudie JD, Rauschecker AM et al (2022) Combining radiomics and deep convolutional neural network features from preoperative MRI for predicting clinically relevant genetic biomarkers in glioblastoma. Neurooncol Adv 4(1):vdac060PubMedPubMedCentral
21.
Zurück zum Zitat Mohammed S, Ravikumar V, Warner E et al (2022) Quantifying T2-FLAIR mismatch using geographically weighted regression and predicting molecular status in lower-grade gliomas. AJNR Am J Neuroradiol 43(1):33–39CrossRefPubMedPubMedCentral Mohammed S, Ravikumar V, Warner E et al (2022) Quantifying T2-FLAIR mismatch using geographically weighted regression and predicting molecular status in lower-grade gliomas. AJNR Am J Neuroradiol 43(1):33–39CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Pope WBSJ, Perlina A, Villablanca JP, Mischel PS, Cloughesy TF (2005) MR Imaging correlates of survival in patients with high-grade gliomas. AJNR Am J Neuroradiol 26:2466–2474PubMedPubMedCentral Pope WBSJ, Perlina A, Villablanca JP, Mischel PS, Cloughesy TF (2005) MR Imaging correlates of survival in patients with high-grade gliomas. AJNR Am J Neuroradiol 26:2466–2474PubMedPubMedCentral
23.
Zurück zum Zitat Lasocki A, Gaillard F, Tacey M, Drummond K, Stuckey S (2016) Incidence and prognostic significance of non-enhancing cortical signal abnormality in glioblastoma. J Med Imaging Radiat Oncol 60(1):66–73CrossRefPubMed Lasocki A, Gaillard F, Tacey M, Drummond K, Stuckey S (2016) Incidence and prognostic significance of non-enhancing cortical signal abnormality in glioblastoma. J Med Imaging Radiat Oncol 60(1):66–73CrossRefPubMed
24.
Zurück zum Zitat Carrillo JA, Lai A, Nghiemphu PL et al (2012) Relationship between tumor enhancement, edema, IDH1 mutational status, MGMT promoter methylation, and survival in glioblastoma. AJNR Am J Neuroradiol 33(7):1349–1355CrossRefPubMedPubMedCentral Carrillo JA, Lai A, Nghiemphu PL et al (2012) Relationship between tumor enhancement, edema, IDH1 mutational status, MGMT promoter methylation, and survival in glioblastoma. AJNR Am J Neuroradiol 33(7):1349–1355CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Han S, Liu Y, Cai SJ et al (2020) IDH mutation in glioma: molecular mechanisms and potential therapeutic targets. Br J Cancer 122(11):1580–1589CrossRefPubMedPubMedCentral Han S, Liu Y, Cai SJ et al (2020) IDH mutation in glioma: molecular mechanisms and potential therapeutic targets. Br J Cancer 122(11):1580–1589CrossRefPubMedPubMedCentral
26.
27.
Zurück zum Zitat Suh CH, Kim HS, Jung SC, Choi CG, Kim SJ (2018) Clinically relevant imaging features for MGMT promoter methylation in multiple glioblastoma studies: a systematic review and meta-analysis. AJNR Am J Neuroradiol 39(8):1439–1445PubMedPubMedCentral Suh CH, Kim HS, Jung SC, Choi CG, Kim SJ (2018) Clinically relevant imaging features for MGMT promoter methylation in multiple glioblastoma studies: a systematic review and meta-analysis. AJNR Am J Neuroradiol 39(8):1439–1445PubMedPubMedCentral
28.
Zurück zum Zitat Yogananda CGB, Shah BR, Nalawade SS et al (2021) MRI-based deep-learning method for determining glioma MGMT promoter methylation status. AJNR Am J Neuroradiol 42(5):845–852CrossRefPubMedPubMedCentral Yogananda CGB, Shah BR, Nalawade SS et al (2021) MRI-based deep-learning method for determining glioma MGMT promoter methylation status. AJNR Am J Neuroradiol 42(5):845–852CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat Kinoshita M, Arita H, Takahashi M et al (2020) Impact of inversion time for FLAIR acquisition on the T2-FLAIR mismatch detectability for IDH-mutant, non-CODEL astrocytomas. Front Oncol 10:596448CrossRefPubMed Kinoshita M, Arita H, Takahashi M et al (2020) Impact of inversion time for FLAIR acquisition on the T2-FLAIR mismatch detectability for IDH-mutant, non-CODEL astrocytomas. Front Oncol 10:596448CrossRefPubMed
Metadaten
Titel
Association of partial T2-FLAIR mismatch sign and isocitrate dehydrogenase mutation in WHO grade 4 gliomas: results from the ReSPOND consortium
verfasst von
Matthew D. Lee
Sohil H. Patel
Suyash Mohan
Hamed Akbari
Spyridon Bakas
MacLean P. Nasrallah
Evan Calabrese
Jeffrey Rudie
Javier Villanueva-Meyer
Pamela LaMontagne
Daniel S. Marcus
Rivka R. Colen
Carmen Balana
Yoon Seong Choi
Chaitra Badve
Jill S. Barnholtz-Sloan
Andrew E. Sloan
Thomas C. Booth
Joshua D. Palmer
Adam P. Dicker
Adam E. Flanders
Wenyin Shi
Brent Griffith
Laila M. Poisson
Arnab Chakravarti
Abhishek Mahajan
Susan Chang
Daniel Orringer
Christos Davatzikos
Rajan Jain
the ReSPOND Consortium
Publikationsdatum
19.07.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Neuroradiology / Ausgabe 9/2023
Print ISSN: 0028-3940
Elektronische ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-023-03196-9

Kompaktes Leitlinien-Wissen Neurologie (Link öffnet in neuem Fenster)

Mit medbee Pocketcards schnell und sicher entscheiden.
Leitlinien-Wissen kostenlos und immer griffbereit auf ihrem Desktop, Handy oder Tablet.

Neu im Fachgebiet Neurologie

Kaliumhaltiges Kochsalz schützt vor Schlaganfallrezidiven

Erhalten Menschen nach einem Schlaganfall statt normalem Kochsalz eine kaliumhaltige Alternative, reduziert dies sowohl das Risiko für erneute ischämische und hämorrhagische Insulte als auch die Gesamtmortalität. Dafür sprechen Ergebnisse einer großen randomisierten Studie.

Der Mann mit der Alzheimermutation, der keine Demenz bekommt

Nur sehr selten werden Menschen mit einer Alzheimermutation von einer familiären Demenz verschont, was meist an protektiven Genvarianten liegt. Ein über 70-jähriger Mann stellt die Forschung jedoch vor ein Rätsel. Vielleicht hat ihm die Arbeit in großer Hitze geholfen.

Auch nach TIA kommt es zu kognitivem Abbau

Trotz raschem und vollständigem Verschwinden der Symptome bergen auch transitorische ischämische Attacken das Risiko langfristigen kognitiven Abbaus, wie eine Studie zeigt. Die Größenordnung gleicht jener nach einem Schlaganfall.

Schlaganfall oder Schlaganfall-Imitator?

Ein breites Spektrum von Erkrankungen kann einen Schlaganfall vortäuschen. Bei der notwendigen schnellen Unterscheidung zwischen solchen „stroke mimics“ und echten Schlaganfällen können einige klinische Faktoren und Symptome unterstützend herangezogen werden. 

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.