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Automated apparent diffusion coefficient analysis for genotype prediction in lower grade glioma: association with the T2-FLAIR mismatch sign.
Aliotta, Eric; Dutta, Sunil W; Feng, Xue; Tustison, Nicholas J; Batchala, Prem P; Schiff, David; Lopes, M Beatriz; Jain, Rajan; Druzgal, T Jason; Mukherjee, Sugoto; Patel, Sohil H.
Afiliación
  • Aliotta E; Department of Radiation Oncology, University of Virginia, Charlottesville, VA, 22908, USA.
  • Dutta SW; Department of Radiation Oncology, University of Virginia, Charlottesville, VA, 22908, USA.
  • Feng X; Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, 22908, USA.
  • Tustison NJ; Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, 22908, USA.
  • Batchala PP; Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, 22908, USA.
  • Schiff D; Departments of Neurology, Neurological Surgery, and Medicine, University of Virginia, Charlottesville, VA, 22908, USA.
  • Lopes MB; Departments of Pathology (Neuropathology) and Neurological Surgery, University of Virginia, Charlottesville, VA, 22908, USA.
  • Jain R; Departments of Radiology and Neurosurgery, NYU-Langone Medical Center, New York, NY, 10016, USA.
  • Druzgal TJ; Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, 22908, USA.
  • Mukherjee S; Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, 22908, USA.
  • Patel SH; Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, 22908, USA. shp4k@virginia.edu.
J Neurooncol ; 149(2): 325-335, 2020 Sep.
Article en En | MEDLINE | ID: mdl-32909115
PURPOSE: The prognosis of lower grade glioma (LGG) patients depends (in large part) on both isocitrate dehydrogenase (IDH) gene mutation and chromosome 1p/19q codeletion status. IDH-mutant LGG without 1p/19q codeletion (IDHmut-Noncodel) often exhibit a unique imaging appearance that includes high apparent diffusion coefficient (ADC) values not observed in other subtypes. The purpose of this study was to develop an ADC analysis-based approach that can automatically identify IDHmut-Noncodel LGG. METHODS: Whole-tumor ADC metrics, including fractional tumor volume with ADC > 1.5 × 10-3mm2/s (VADC>1.5), were used to identify IDHmut-Noncodel LGG in a cohort of N = 134 patients. Optimal threshold values determined in this dataset were then validated using an external dataset containing N = 93 cases collected from The Cancer Imaging Archive. Classifications were also compared with radiologist-identified T2-FLAIR mismatch sign and evaluated concurrently to identify added value from a combined approach. RESULTS: VADC>1.5 classified IDHmut-Noncodel LGG in the internal cohort with an area under the curve (AUC) of 0.80. An optimal threshold value of 0.35 led to sensitivity/specificity = 0.57/0.93. Classification performance was similar in the validation cohort, with VADC>1.5 ≥ 0.35 achieving sensitivity/specificity = 0.57/0.91 (AUC = 0.81). Across both groups, 37 cases exhibited positive T2-FLAIR mismatch sign-all of which were IDHmut-Noncodel. Of these, 32/37 (86%) also exhibited VADC>1.5 ≥ 0.35, as did 23 additional IDHmut-Noncodel cases which were negative for T2-FLAIR mismatch sign. CONCLUSION: Tumor subregions with high ADC were a robust indicator of IDHmut-Noncodel LGG, with VADC>1.5 achieving > 90% classification specificity in both internal and validation cohorts. VADC>1.5 exhibited strong concordance with the T2-FLAIR mismatch sign and the combination of both parameters improved sensitivity in detecting IDHmut-Noncodel LGG.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Encefálicas / Biomarcadores de Tumor / Aberraciones Cromosómicas / Imagen de Difusión por Resonancia Magnética / Glioma / Mutación Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans / Male / Middle aged Idioma: En Revista: J Neurooncol Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Encefálicas / Biomarcadores de Tumor / Aberraciones Cromosómicas / Imagen de Difusión por Resonancia Magnética / Glioma / Mutación Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans / Male / Middle aged Idioma: En Revista: J Neurooncol Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos