MRI characteristics predict BRAF V600E status in gangliogliomas and pleomorphic xanthoastrocytomas and provide survival prognostication

Background BRAF V600E mutation is a common genomic alteration in gangliogliomas (GGs) and pleomorphic xanthoastrocytomas (PXAs) with prognostic and therapeutic implications. Purpose To investigate the ability of magnetic resonance imaging (MRI) features to predict BRAF V600E status in GGs and PXAs and their prognostic values. Material and Methods A cohort of 44 patients with histologically confirmed GGs and PXAs was reviewed retrospectively. BRAF V600E status was determined by immunohistochemistry (IHC) staining and fluorescence quantitative polymerase chain reaction (PCR). Demographics and MRI characteristics of the two groups were evaluated and compared. Univariate and multivariate Cox regression analyses were performed to identify MRI features that were prognostic for progression-free survival (PFS). Results T1/FLAIR ratio, enhancing margin, and mean relative apparent diffusion coefficient (rADC mea ) value showed significant differences between the BRAF V600E-mutant and BRAF V600E-wild groups (all P < 0.05). Binary logistic regression analysis revealed only rADC mea value was the independent predictive factor for BRAF V600E status ( P = 0.027). Univariate Cox regression analysis showed age at diagnosis ( P = 0.032), WHO grade ( P = 0.020), enhancing margin ( P = 0.029), and rADC mea value ( P = 0.005) were significant prognostic factors for PFS. In multivariate Cox regression analysis, increasing age ( P = 0.040, hazard ratio [HR] = 1.04, 95% confidence interval [CI] = 1.002–1.079) and lower rADC mea values ( P = 0.021, HR = 0.036, 95% CI = 0.002–0.602) were associated with poor PFS in GGs and PXAs. Conclusion Imaging features are potentially predictive of BRAF V600E status in GGs and PXAs. Furthermore, rADC mea value is a valuable prognostic factor for patients with GGs or PXAs.