作者
Matthew D. Lee,Sohil H. Patel,Suyash Mohan,Hamed Akbari,Spyridon Bakas,MacLean P. Nasrallah,Evan Calabrese,Jeffrey D. Rudie,Javier E. Villanueva‐Meyer,Pamela LaMontagne,Dan Marcus,Rivka R. Colen,Carmen Balaña,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 Poisson,Arnab Chakravarti,Abhishek Mahajan,Susan M. Chang,Daniel A. Orringer,Christos Davatzikos,Rajan Jain,Stephen Bagley,Michel Bilello,Steven Brem,Ujjwal Baid,Arati Desai,Robert A. Lustig,Elizabeth Mamourian,Anahita Fathi Kazerooni,Jose Garcia,Donald M. O’Rourke,Zev A. Binder,Mikhail Milchenko,Arash Nazeri,Aristeidis Sotiras,Murat Ak,Jaume Capellades,Josep Puig,Sung Soo Ahn,Jong Hee Chang,Seung Koo Lee,Yae Won Park,Vachan Vadmal,Kristin Waite,Sree Gongala,Alysha Chelliah,Golestan Karami,Gregory S. Alexander,Ayesha Ali,Spencer Liem,Joseph Lombardo,Gaurav Shukla,Muhammad Sharif,Lisa Rogers,William D. Taylor,Santiago Cepeda,Aikaterini Kotrotsou,Hassan M. Fathallah‐Shaykh,Orazio Santo Santonocito,Anna Luisa Di Stefano,Aaron Rulseh,Yuji Matsumoto,Kimberley Alexander-Kaufman,Laveniya Satgunaseelan,Benedikt Wiestler,Rao P. Gullapalli,Elias R. Melhem,Graeme F. Woodworth,Peter Kamel,Víctor M. Pérez‐García,Alexandros Vamvakas,Ioannis Tsougos,Pablo Valdés,Pallavi Tiwari,Mariam Aboian
摘要
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.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).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.Partial T2-FLAIR mismatch sign is highly specific for IDH mutation in WHO grade 4 gliomas.