Nimg-29. Association of Partial T2-flair Mismatch Sign and Isocitrate Dehydrogenase Mutation in Who Grade 4 Glioma/glioblastoma: Results From the Respond Consortium
Year: 2022
Type: article
Study design: Observational Study
Abstract: PURPOSE T2-FLAIR mismatch (T2FM) is a highly specific imaging biomarker for isocitrate dehydrogenase (IDH) mutation in low-grade gliomas. Previous T2FM studies are inconsistent for glioblastoma (GBM)/grade-4 glioma, partly due to low IDH-mutation prevalence in high-grade gliomas. We leveraged a large multi-institutional GBM/grade-4 glioma cohort to analyze the association of partial T2FM and IDH-mutation (T2-hyperintense, FLAIR-hypointense, nonenhancing, nonedema). METHODS We analyzed preoperative MRI of 1500 pathologically confirmed GBM/grade-4 gliomas with known IDH-mutation status from the ReSPOND consortium, consisting of the following institutions (sample size): Ivy GBM Atlas Project (33), Catalan Institute of Oncology (132), Case Western Reserve University/University Hospitals (132), New York University (55), Ohio State University (25), University of Pennsylvania (641), University Hospital Río Hortega (16), Yonsei University Health System (118), The Cancer Imaging Archive (93), Thomas Jefferson University (48), Tata Memorial Hospital (22), University of Pittsburgh Medical Center (156), and Washington University School of Medicine in St. Louis (57). Sequences were co-registered to a common anatomic atlas. Continuous variables were compared by t-test and categorical variables by Χ 2-test. RESULTS 71 (4.7%) were IDH-mutants, significantly younger (43±1 v. 62±12 years, p=5x10-37), and more likely to exhibit partial T2FM (20% v. 0.4%, p=1x10-43), frontal lobe predominance (68% v. 29%, p=7x10-12), nonenhancing components (T2/FLAIR-intermediate signal, nonedema; 45% v. 9%, p=1x10-22), and cystic components (smooth margins, no/minimal enhancement, homogeneous FLAIR suppression; 17% v. 3%, p=7x10-11) than IDH-wildtypes. 20 cases had partial T2FM (14 IDH-mutant, 6 IDH-wildtype). Sensitivity of partial T2FM for IDH-mutation was 19.7%, specificity 99.6%, positive predictive value 70%, and negative predictive value 96.1%. Subset analysis of 983 IDH-wildtypes with known MGMT methylation status (406 MGMT-hypermethylated) showed frontal lobe predominance was more common in MGMT-hypermethylated than MGMT-unmethylated (39.4% v. 24.3%, p=.02); other imaging characteristics did not significantly differ. CONCLUSIONS Partial T2FM is a highly specific imaging biomarker for IDH-mutation in GBM/grade-4 glioma.
Source: Neuro-Oncology
Authors: Matthew Lee, Chiharu Sako, Sohil Patel, Suyash Mohan, Carmen Balana, Jill Barnholtz-Sloan, Andrew Sloan, Chaitra Badve, Laila Poisson, Brent Griffith, Thomas Booth, Joshua Palmer, Arnab Chakravarti, Spyridon Bakas, MacLean Nasrallah, Yoon Seong Choi, Adam Dicker, Adam Flanders, Wenyin Shi, Abhishek Mahajan, Rivka Colen, Daniel Marcus, Daniel Orringer, Christos Davatzikos, Rajan Jain
Institutions: New York University, University of Pennsylvania, University of Virginia Medical Center, University of Virginia, Institut Català d'Oncologia, National Cancer Institute, Division of Cancer Epidemiology and Genetics, University Hospitals Cleveland Medical Center, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Henry Ford Health, Henry Ford Hospital, King's College London, The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Wexner Medical Center, The Ohio State University, Yonsei University, Yonsei University Health System, Thomas Jefferson University, Sidney Kimmel Cancer Center, Thomas Jefferson University Hospital, Clatterbridge Cancer Centre NHS Foundation Trust, University of Pittsburgh, Washington University in St. Louis
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4308976786