Diagnostic performance of multiparametric nonenhanced magnetic resonance imaging (MRI) in grading glioma and correlating IDH mutation status

To evaluate the diagnostic performance of nonenhanced magnetic resonance imaging (MRI) in grading glioma and correlating isocitrate dehydrogenase (IDH) mutation status.

Patients with diagnoses confirmed by postoperative pathology were enrolled. Quantitative parameters, including the relative amide proton transfer-weighted (rAPTW), relative cerebral blood flow (CBF), and apparent diffusion coefficient (ADC) were applied to grade gliomas and correlate IDH mutation status. MRI parameters were compared with an independent-sample t-test. The diagnostic performance was assessed and compared with a receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC).

The rAPTW signal and rCBF values were significantly higher in high-grade gliomas (HGG) than in low-grade glioma (LGG), whereas ADC values were significantly lower in HGG than in LGG. Compared with 3D-pCASL imaging and diffusion-weighted imaging (DWI), 3D-APTW imaging had the best diagnostic performance in distinguishing LGG from HGG, with an AUC of 0.930, a sensitivity of 91.2% and a specificity of 87.5%. By adding 3D-APTW imaging to 3D-pCASL imaging, or DWI, the diagnostic performance of both sequences increased. Furthermore, APTW, rAPTW, CBF, and rCBF values in the IDH mutant-type (IDH-mut) group were significantly lower than those in the IDH wild-type (IDH-wt) group, ADC values were significantly higher in IDH-mut group than in IDH-wt group.

3D-APTW imaging demonstrated better diagnostic performance than DWI or 3D-pCASL imaging in grading gliomas. Moreover, 3D-APTW imaging had added value in addition to both 3D-pCASL imaging and DWI in distinguishing LGG from HGG. 3D-APTW, 3D-pCASL, and DWI imaging could be used to discriminate between IDH-mut and IDH-wt group.