The isocitrate dehydrogenase (IDH) mutation status is a recognized molecular biomarker for glioma stratification. In addition, glioma clinical management benefits from advanced MRI sequences including diffusion tensor imaging (DTI). For first time, we investigated the diagnostic power of DTI to characterize gliomas with respect to IDH mutation status.
This retrospective study examines the accuracy of DTI for staging of IDH mutant (98) and wild-type (67) gliomas in a treatment-naïve setting. The tumour was manually segmented in the MRI and two DTI-derived parameters, namely fractional anisotropy (FA) and mean diffusivity (MD) values were calculated and plotted as histograms. Thresholds for the optimal diagnostic performance in terms of IDH mutation were sought in selected histogram parameters of FA and MD maps using parametric and non-parametric tests as well as receiver operating characteristic curve analysis.
Significantly higher MD median values and significantly lower FA median values were observed in the IDH mutant compared with the wild-type group. As follows, the median MD value was defined as a robust predictor for IDH mutation status [area under the curve (AUC) = 0.82]. The developed logistic regression model included the top 5 correlating histogram parameters and the patient age. The assessment using the parameter combination reached better performance (AUC=0.85) compared with the prediction using parameter of the median MD value alone.
MR imaging DTI-derived metrics (MD and FA values) in combination with demographic information has the potential to non-invasively predict molecular stratification of gliomas.
Clinical trial identification
Legal entity responsible for the study
University College London.
Has not received any funding.
D. Roettger: Head of Scientific and Medical Affairs: IAG. All other authors have declared no conflicts of interest.