NEURORADIOLOGY / ORIGINAL PAPER
Prediction of isocitrate dehydrogenase mutation status in WHO grade II glioma by diffusion kurtosis imaging
More details
Hide details
1
Shanxi Traditional Chinese Medical Hospital, Shanxi, China
2
First Hospital of Shanxi Medical University, Shanxi, China
These authors had equal contribution to this work
Submission date: 2024-07-29
Final revision date: 2024-08-23
Acceptance date: 2024-11-03
Corresponding author
Hui Zhang
First Hospital of Shanxi Medical University, Shanxi, China, e-mail: huizhangmri@163.com
Pol J Radiol, 2024; 89: 566-572
KEYWORDS
TOPICS
ABSTRACT
Purpose:
Isocitrate dehydrogenase (IDH) mutation status serves as a crucial prognostic indicator for glioma, typically assessed via immunohistochemical analysis post-surgery. Given the invasiveness of this approach, perhaps we can utilise convenient and noninvasive magnetic resonance imaging (MRI) methods to predict IDH mutation status. However, the current landscape lacks a standardised MRI technique for accurately predicting IDH mutations. In this study, we explore the potential of MRI diffusion kurtosis imaging (DKI) in forecasting the IDH mutation status of WHO grade II brain gliomas.
Material and methods:
Twenty-five patients with WHO grade II gliomas were retrospectively included. Patients underwent routine MRI and DKI scanning before surgery, measuring tumoural solid portion, peritumoral oedema, and normal-appearing white matter (NAWM) DKI parameters, including fractional anisotropy (FA), mean diffusivity (MD), mean kurtosis (MK), axial kurtosis (Ka), and axial radial kurtosis (Kr). The DKI parameter corrections were made (tumour or oedema parameters values divided by the NAWM value) to obtain the rFA (ratio of FA), rMD (ratio of MD), rMK (ratio of MK), rKA (ratio of KA), and rKr (ratio of Kr) values. Postoperative specimens were made of wx blocks and analysed by Sanger gene sequencing. DKI parameters between the 2 groups were compared by independent sample t-tests. The ROC curve was used to analyse the diagnostic value of each parameter.
Results:
Twenty-five patients were diagnosed with IDH-mutant (16 cases) and IDH-wild type (9 cases). The rFA and rMK values in the parenchymal region of IDH wild-type tumour were higher than those of IDH mutant, while the rMD values were lower than those of IDH mutant, and the difference between them was statistically significant (p < 0.05). The values of DKI parameters of peritumoral oedema in the 2 groups were not statistically significant.
Conclusions:
DKI can provide microstructural changes of diseased tissues and provide more imaging information for preoperative non-invasive judgment of IDH mutation status of WHO grade II gliomas. The values of rMK, rFA, and rMD are helpful in the assessment IDH mutation status, benefiting accurate diagnoses and treatment decisions.
REFERENCES (21)
1.
Parson DW, Jones S, Zhang X, Cheng-Ho Lin J, Leary RJ, Angenendt P, et al. An integrated genomic analysis of human glioblastoma multiform. Science 2008; 321: 1807-1812.
2.
Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 2016; 131: 803-820.
3.
Louis DN, Perry A, Wesseling P, Brat DJ, Cree IA, Figarella-Branger D, et al. The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro Oncol 2021; 23: 1231-1251.
4.
Miller JJ, Gonzalez Castro LN, McBrayer S, Weller M, Cloughesy T, Portnow J, et al. Isocitrate dehydrogenase (IDH) mutant gliomas: a Society for Neuro-Oncology (SNO) consensus review on diagnosis, management, and future directions. Neuro Oncol 2023; 25: 4-25.
5.
Raab P, Hattingen E, Franz K, Zanella FE, Lanfermann H. Cerebral gliomas: diffusional kurtosis imaging analysis of microstructural differences. Radiology 2010; 254: 876-881.
6.
Tan Y, Zhang H, Wang X, Qin J, Wang L, Yang G, et al. Comparing the value of DKI and DTI in detecting isocitrate dehydrogenase genotype of astrocytomas. Clin Radiol 2019; 74: 314-320.
7.
Aibaidula A, Ka-Yin Chan A, Shi Z, Li Y, Zhang R, Yang R, et al. Adult IDH wild-type lower-grade gliomas should be further stratified. Neuro Oncol 2017; 19: 1327-1337.
8.
Weller M, Wen PY, Chang SM, Dirven L, Lim M, Monje M, et al. Glioma. Nat Rev Dis Primers 2024; 10: 33. DOI: 10.1038/s41572-024-00516-y.
9.
Hyare H, Rice L, Thuse S, Nachev P, Jha A, Milic M, et al. Modelling MR and clinical features in grade II/III astcytomas to predict IDH mutation status. Eur J Radiol 2019; 114: 120-127.
10.
Li Y, Qin Q, Zhang Y, Cao Y. Noninvasive determination of the IDH status of gliomas using MRI and MRI-based radiomics: impact on diagnosis and prognosis. Curr Oncol 2022; 29: 6893-6907.
11.
Mendez AM, Fang LK, Meriwether CH, Batasin SJ, Loubrie S, Rodríguez-Soto AE, et al. Diffusion breast MRI: current standard and emerging techniques. Front Oncol 2022; 12: 844790. DOI: 10.3389/fonc.2022.844790.
12.
Wu EX, Cheung MM. MR diffusion kurtosis imaging for neural tissue characterization. NMR Biomed 2010; 23: 836-848.
13.
Xu Z, Ke C, Liu J, Xu S, Han L, Yang Y, et al. Diagnostic performance between MR amide proton transfer (APT) and diffusion kurtosis imaging (DKI) in glioma grading and IDH mutation status prediction at 3 T. Eur J Radiol 2021; 134: 109466. DOI: 10.1016/j.ejrad. 2020.109466.
14.
Haopeng P, Xuefei D, Yan R, Zhenwei Y, Wei H, Ziyin W, et al. Diffusion kurtosis imaging differs between primary central nervous system lymphoma and high-grade glioma and is correlated with the diverse nuclear-to-cytoplasmic ratio: a histopathologic, biopsybased study. Eur Radiol 2020; 30: 2125-2137.
15.
Zhao J, Wang YL, Li XB, Hu MS, Li ZH, Song YK, et al. Comparative analysis of the diffusion kurtosis imaging and diffusion tensor imaging in grading gliomas, predicting tumour cell proliferation and IDH-1 gene mutation status. J Neurooncol 2019; 141: 195-203.
16.
Raja R, Sinha N, Saini J, Mahadevan A, Rao KN, Swaminathan A. Assessment of tissue heterogeneity using diffusion tensor and diffusion kurtosis imaging for grading gliomas. Neuroradiology 2016; 58: 1217-1231.
17.
Van Cauter S, Veraart J, Sijbers J, Peeters RR, Himmelreich U, De Keyzer F, et al. Gliomas: diffusion kurtosis MR imaging in grading. Radiology 2012; 263: 492-501.
18.
Beppu T, Inoue T, Shibata Y, Kurose A, Arai H, Ogasawara K, et al. Measurement of fractional anisotropy using diffusion tensor MRI in supratentorial astrocytic tumors. J Neurooncol 2003; 63: 109-116.
19.
Xing Z, Yang X, She D, Lin Y, Zhang Y, Cao D. Noninvasive assessment of IDH mutational status in World Health Organization grade II and III astrocytomas using DWI and DSC-PWI combined with conventional MR imaging. Am J Neuroradiol 2017; 38: 1138-1144.
20.
Zhu H, Xie Y, Li L, Liu Y, Li S, Shen N, et al. Diffusion along the perivascular space as a potential biomarker for glioma grading and isocitrate dehydrogenase 1 mutation status prediction. Quant Imaging Med Surg 2023; 13: 8259-8273.
21.
Solar P, Hendrych M, Barak M, Valekova H, Hermanova M, Jancalek R. Blood-brain barrier alterations and edema formation in different brain mass lesions. Front Cell Neurosci 2022; 16: 922181. DOI: 10.3389/fncel.2022.922181.