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Noninvasive assessment of H3 K27M mutational status in diffuse midline gliomas by using apparent diffusion

Hong Chen1, Wanming Hu2, Haoqiang He3

  • 1Department of Medical Imaging, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, PR China; Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.

European Journal of Radiology
|April 22, 2019
PubMed
Abstract

Insights

H3 K27M-mutant diffuse midline gliomas can be identified noninvasively. Diffusion-weighted imaging (DWI) apparent diffusion coefficient (ADC) ratios accurately predict H3 K27M mutational status in these brain tumors.

Area of Science:

  • Neuro-oncology
  • Radiology
  • Molecular Pathology

Background:

  • H3 K27M-mutant diffuse midline gliomas present a poorer prognosis compared to wild-type gliomas.
  • Accurate identification of H3 K27M mutational status is crucial for treatment planning and prognosis.

Purpose of the Study:

  • To evaluate conventional magnetic resonance imaging (cMRI) features of H3 K27M-mutant gliomas.
  • To determine if diffusion-weighted imaging (DWI) derived apparent diffusion coefficient (ADC) can noninvasively predict H3 K27M mutational status in diffuse midline gliomas.

Main Methods:

  • Retrospective review of 38 patients with diffuse midline gliomas.
  • Analysis of preoperative cMRI parameters, including minimal ADC, peritumoral ADC, and their ratios.
  • Logistic regression and receiver operating characteristic (ROC) curve analysis to assess diagnostic performance.

Main Results:

  • H3 K27M-mutant gliomas exhibited significantly lower minimal ADC, peritumoral ADC, ratio of minimal ADC, and ratio of peritumoral ADC values compared to wild-type gliomas (P < 0.05).
  • The combination of the ratio of minimal ADC and ratio of peritumoral ADC achieved the highest area under the curve (AUC) of 0.872 for predicting H3 K27M mutational status.

Conclusions:

  • Diffusion-weighted imaging (DWI) derived ADC ratios offer a noninvasive method for detecting H3 K27M mutational status in brain diffuse midline gliomas.
  • The combined use of minimal and peritumoral ADC ratios demonstrates high diagnostic performance.
Keywords:
Conventional MRIDiffusion-weighted imagingH3 K27M-mutant

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