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Updated: Nov 22, 2025
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Digital Spatial Profiling for Characterization of the Microenvironment in Adult-Type Diffusely Infiltrating Glioma
Published on: September 13, 2022
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Regional and Volumetric Parameters for Diffusion-Weighted WHO Grade II and III Glioma Genotyping: A Method Comparison
S C Thust1,2,3, J A Maynard4,2, M Benenati2,5
1From the Neuroradiological Academic Unit (S.C.T., J.A.M, S.J.W., L.M., H.R.J.), Department of Brain, Repair and Rehabilitation, UCL Institute of Neurology, London, UK s.thust@ucl.ac.uk.
AJNR. American Journal of Neuroradiology
|January 8, 2021
Summary
Regional ADC measurements effectively predict isocitrate dehydrogenase (IDH) wild-type gliomas, similar to volumetric methods. Volumetric analysis is superior for partially necrotic, rim-enhancing gliomas.
Area of Science:
- Neuroimaging
- Oncology
- Radiology
Background:
- Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values are crucial for glioma characterization.
- Existing studies show varying ADC thresholds for distinguishing isocitrate dehydrogenase (IDH) wild-type from IDH mutant gliomas.
- Standardized ADC measurement techniques are needed for reliable glioma genotyping.
Purpose of the Study:
- To compare volumetric and regional ADC measurement techniques for predicting glioma IDH status.
- To evaluate the accuracy of different ADC metrics in classifying gliomas based on IDH mutation status.
Main Methods:
- Analysis of treatment-naïve World Health Organization grade II and III gliomas (n=283).
- Region of Interest (ROI) and Volume of Interest (VOI) based ADC measurements, including normalized values.
- Logistic regression and nonparametric testing (eta², ANOVA) to assess associations between ADC metrics and IDH genotype.
Main Results:
- IDH status was accurately predicted by both ROI mean normalized ADC (AUC=0.83) and VOI mean normalized ADC (AUC=0.82).
- ROI-based genotyping showed comparable accuracy to volumetric parameters for nonenhancing and solid-patchy enhancing gliomas (AUC=0.81-0.84).
- Volumetric measurements were uniquely predictive for rim-enhancing, centrally necrotic tumors (AUC=0.90).
Conclusions:
- Regional normalized mean ADC measurements are noninferior to volumetric segmentation for solid glioma IDH status determination.
- Volumetric ADC quantification is recommended for partially necrotic, rim-enhancing gliomas due to ROI assessment limitations.
