Imaging-Based Molecular Characterization of Adult-Type Diffuse Glioma Using Diffusion and Perfusion MRI in Pre- and...

Area of Science:

• Neuro-oncology
• Radiology
• Molecular Diagnostics

Background:

• Accurate molecular characterization of adult-type diffuse gliomas is crucial for selecting appropriate treatments.
• Imaging techniques offer a non-invasive method for assessing key molecular markers.

Purpose of the Study:

• To evaluate the utility of diffusion and perfusion MRI in determining isocitrate dehydrogenase (IDH) mutation and epidermal growth factor receptor (EGFR) amplification status.
• To investigate the impact of spatial and temporal heterogeneity on imaging-based molecular marker assessment in primary and recurrent gliomas.

Main Methods:

• Retrospective analysis of 312 newly diagnosed and 38 recurrent adult-type diffuse glioma patients.
• Extraction of radiomics features from apparent diffusion coefficient and perfusion maps of contrast-enhancing tumors and non-enhancing lesions.
• Development of predictive models for IDH and EGFR status using LASSO regression on cross-sectional and longitudinal imaging data.

Main Results:

• High diagnostic performance (AUC > 0.93) for IDH mutation status was achieved using both cross-sectional and longitudinal MRI data.
• The 'concordant model' using stable longitudinal features maintained strong IDH prediction in recurrent gliomas (AUC = 0.919).
• MRI demonstrated limited accuracy for EGFR amplification detection, especially in recurrent tumors (AUC < 0.52).

Conclusions:

• Diffusion and perfusion MRI are effective for characterizing IDH status in both newly diagnosed and recurrent gliomas.
• The diagnostic performance of MRI for EGFR amplification is suboptimal, particularly in the context of tumor recurrence.
• Imaging-based molecular profiling shows promise but requires further refinement for certain genetic alterations.