AB084. T2-fluid-attenuated inversion recovery (T2-FLAIR) mismatch as predictive MRI findings of diffuse astrocytoma: a case report
Year: 2024
Type: conference-abstract
Abstract: BACKGROUND: Diffuse astrocytomas are a subtype of astrocytic tumors classified as World Health Organization (WHO) grade II tumors. Magnetic resonance imaging is a useful diagnostic tool for assessing diffuse astrocytomas. However, their growth pattern resembles other low-grade gliomas, such as oligodendroglioma. The potential magnetic resonance imaging (MRI) feature, T2-fluid-attenuated inversion recovery (T2-FLAIR) mismatch, may be predictive in identifying diffuse astrocytomas. This involves a hyperintense signal in T2-weighted and a hypointense signal in T2-FLAIR, which oligodendroglioma does not exhibit. CASE DESCRIPTION: A 30-year-old female seeks medical advice regarding her complaint of persistent headaches. The clinical findings suggested an anaplastic oligodendroglioma, and an MRI examination was requested to confirm. At first glance, MRI findings showed multiple cystic intratumoral and calcification, which is prone to oligodendroglioma diagnosis. However, a T2-FLAIR mismatch was observed upon closer examination, with a hyperintense signal in T2-weighted imaging and a hypointense signal in T2-FLAIR, potentially leading to diffuse astrocytoma diagnosis. Moreover, the histopathological analysis revealed isocitrate dehydrogenase (IDH)-mutant findings consistent with the characteristics of diffuse astrocytoma. Our findings of the observed T2-FLAIR mismatch were consistent with other reported cases and studies that have indicated the potential predictive value of T2-FLAIR mismatch in identifying diffuse astrocytomas. This case highlights the importance of careful observation and close examination of MRI findings, especially in differentiating between similar low-grade gliomas. The presence of a T2-FLAIR mismatch can aid clinicians in making informed decisions regarding the diagnosis and subsequent treatment plan for patients presenting with symptoms suggestive of astrocytic tumors. CONCLUSIONS: In conclusion, the T2-FLAIR mismatch sign is consistent with being the radiogenomic signature of IDH-mutant diffuse astrocytomas, as seen in our case report.
Source: Chinese Clinical Oncology
Authors: Rifki Bachtiar, Nurhuda Hendra Setyawan
Institution: Universitas Gadjah Mada
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4401616545