Noninvasive Assessment ofIDHMutational Status in World Health Organization Grade II and III Astrocytomas Using DWI and DSC-PWI Combined with Conventional MR Imaging

Abstract

A combination of conventional MR imaging, DWI, and DSC-PWI techniques produces a high sensitivity, specificity, positive predictive value, and negative predictive value for predicting mutations in grade II and III astrocytomas. The strategy of using advanced, semiquantitative MR imaging techniques may provide an important, noninvasive, surrogate marker that should be studied further in larger, prospective trials.

Magnetic Resonance Imaging Derived Biomarkers of IDH Mutation Status and Overall Survival in Grade III Astrocytomas

“…Furthermore, in our population, the presence/absence of edema was not related to a particular subgroup. Moreover, we did not find significant differences about the border's features on FLAIR sequences, although the majority (60%) of IDH-Mut showed well-defined profiles, as reported in the literature [8,15].…”

“…The placement of the region of interests (ROIs) was performed as previously described by Xing Z. et al [15]. In particular, to ensure precise ROIs placements on the solid tumor components and avoid cystic, hemorrhagic and necrotic areas or peritumoral edema, the DWI images were co-registered with conventional MRI (FSE T1w pre-gadolinium and 3D FSPGR post-gadolinium and T2w FRFSE).…”

“…In particular, inverse significant correlations between ADC, cell count and ki67 have been reported [12,13]. Recently, some studies have shown that ADC maps may easily discriminate the IDH mutations status, but most of them did not consider a homogeneous group of gliomas in terms of grading and histology [14][15][16][17][18]. Indeed, ADC can be influenced by histology and grading [19][20][21][22].…”

Isocitrate dehydrogenase‐mutant glioma: Evolving clinical and therapeutic implications

“…This is supported by report of hypoperfusion in IDH ‐mutant gliomas . Decreased permeability of the blood‐brain barrier may be related to the inhibition of angiogenesis in IDH ‐mutant glioma …”

“…49 Decreased permeability of the bloodbrain barrier may be related to the inhibition of angiogenesis in IDH-mutant glioma. 50,51 The most striking clinical correlation that reinforced the theory that IDH-mutant gliomas behave differently is the finding that patients with an IDH-mutant glioma live longer than patients with IDH wild-type glioma. There were hints of this survival advantage when recurrent IDH1 mutations were first reported in 2008 by Parsons et al, in which the authors noted that the patients with IDH-mutant glioblastoma survived a median of 31 months compared with 15 months in patients with IDH wild-type glioblastoma.…”