Prediction of isocitrate dehydrogenase genotype in brain gliomas with MRI: Single-shell versus multishell diffusion models

Matteo Figini, Marco Riva, Mark Graham, Gian Marco Castelli, Bethania Fernandes, Marco Grimaldi, Giuseppe Baselli, Federico Pessina, Lorenzo Bello, Hui Zhang, Alberto Bizzi

Research output: Contribution to journalArticle

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Abstract

Purpose: The primary aim of this prospective observational study was to assess whether diffusion MRI metrics correlate with isocitrate dehydrogenase (IDH) status in grade II and III gliomas. A secondary aim was to investigate whether multishell acquisitions with advanced models such as neurite orientation dispersion and density imaging (NODDI) and diffusion kurtosis imaging offer greater diagnostic accuracy than diffusion-tensor imaging (DTI). Materials and Methods: Diffusion MRI (b = 700 and 2000 sec/mm2) was performed preoperatively in 192 consecutive participants (113 male and 79 female participants; mean age, 46.18 years; age range, 14–77 years) with grade II (n = 62), grade III (n = 58), or grade IV (n = 72) gliomas. DTI, diffusion kurtosis imaging, and NODDI metrics were measured in regions with or without hyperintensity on diffusion MR images and compared among groups defined according to IDH genotype, 1p/19q codeletion status, and tumor grade by using Mann-Whitney tests. Results: In grade II and III IDH wild-type gliomas, the maximum fractional anisotropy, kurtosis anisotropy, and restriction fraction were significantly higher and the minimum mean diffusivity was significantly lower than in IDH-mutant gliomas (P = .011, P = .002, P = .044, and P = .027, respectively); areas under the receiver operating characteristic curve ranged from 0.72 to 0.76. In IDH wild-type gliomas, no difference among grades II, III, and IV was found. In IDH-mutant gliomas, no difference between those with and those without 1p/19q loss was found. Conclusion: Diffusion MRI metrics showed correlation with isocitrate dehydrogenase status in grade II and III gliomas. Advanced diffusion MRI models did not add diagnostic accuracy, supporting the inclusion of a single-shell diffusion-tensor imaging acquisition in brain tumor imaging protocols.

Original languageEnglish
Pages (from-to)788-796
Number of pages9
JournalRadiology
Volume289
Issue number3
DOIs
Publication statusPublished - Dec 1 2018

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Isocitrate Dehydrogenase
Glioma
Genotype
Diffusion Magnetic Resonance Imaging
Brain
Diffusion Tensor Imaging
Anisotropy
Neurites
Neuroimaging
ROC Curve
Brain Neoplasms
Observational Studies
Prospective Studies

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Prediction of isocitrate dehydrogenase genotype in brain gliomas with MRI : Single-shell versus multishell diffusion models. / Figini, Matteo; Riva, Marco; Graham, Mark; Castelli, Gian Marco; Fernandes, Bethania; Grimaldi, Marco; Baselli, Giuseppe; Pessina, Federico; Bello, Lorenzo; Zhang, Hui; Bizzi, Alberto.

In: Radiology, Vol. 289, No. 3, 01.12.2018, p. 788-796.

Research output: Contribution to journalArticle

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abstract = "Purpose: The primary aim of this prospective observational study was to assess whether diffusion MRI metrics correlate with isocitrate dehydrogenase (IDH) status in grade II and III gliomas. A secondary aim was to investigate whether multishell acquisitions with advanced models such as neurite orientation dispersion and density imaging (NODDI) and diffusion kurtosis imaging offer greater diagnostic accuracy than diffusion-tensor imaging (DTI). Materials and Methods: Diffusion MRI (b = 700 and 2000 sec/mm2) was performed preoperatively in 192 consecutive participants (113 male and 79 female participants; mean age, 46.18 years; age range, 14–77 years) with grade II (n = 62), grade III (n = 58), or grade IV (n = 72) gliomas. DTI, diffusion kurtosis imaging, and NODDI metrics were measured in regions with or without hyperintensity on diffusion MR images and compared among groups defined according to IDH genotype, 1p/19q codeletion status, and tumor grade by using Mann-Whitney tests. Results: In grade II and III IDH wild-type gliomas, the maximum fractional anisotropy, kurtosis anisotropy, and restriction fraction were significantly higher and the minimum mean diffusivity was significantly lower than in IDH-mutant gliomas (P = .011, P = .002, P = .044, and P = .027, respectively); areas under the receiver operating characteristic curve ranged from 0.72 to 0.76. In IDH wild-type gliomas, no difference among grades II, III, and IV was found. In IDH-mutant gliomas, no difference between those with and those without 1p/19q loss was found. Conclusion: Diffusion MRI metrics showed correlation with isocitrate dehydrogenase status in grade II and III gliomas. Advanced diffusion MRI models did not add diagnostic accuracy, supporting the inclusion of a single-shell diffusion-tensor imaging acquisition in brain tumor imaging protocols.",
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T2 - Single-shell versus multishell diffusion models

AU - Figini, Matteo

AU - Riva, Marco

AU - Graham, Mark

AU - Castelli, Gian Marco

AU - Fernandes, Bethania

AU - Grimaldi, Marco

AU - Baselli, Giuseppe

AU - Pessina, Federico

AU - Bello, Lorenzo

AU - Zhang, Hui

AU - Bizzi, Alberto

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