KEY TAKEAWAYS
- The study aimed to use synthetic MRI to quantitatively differentiate astrocytoma from oligodendroglioma.
- Results showed synthetic MRI improved differentiation of IDH-mutant gliomas, outperforming conventional T2-FLAIR mismatch sign.
The T2-FLAIR mismatch sign is a key imaging biomarker for IDH-mutant astrocytoma. However, interpretations of this sign can vary due to the subjective nature of visual assessment. Additionally, MR sequence parameters can affect the appearance of the T2-FLAIR mismatch sign in brain cancer cases.
To address these challenges, Shumpei Onishi and the team employed synthetic MRI to quantitatively distinguish between astrocytoma and oligodendroglioma.
The study included 20 patients with newly diagnosed non-enhanced IDH-mutant diffuse glioma who underwent preoperative synthetic MRI using the QRAPMASTER sequence.
The conventional MR images were assessed by 2 independent reviewers to identify the T2-FLAIR mismatch sign. Synthetic MRI measured T1, T2, and proton density values in the tumors. ROC curve analysis was conducted to evaluate diagnostic performance.
The pathological diagnoses included 12 patients with IDH-mutant astrocytoma and 8 with IDH-mutant, 1p/19q-codeleted oligodendroglioma. The T2-FLAIR mismatch sign had a sensitivity of 66.7% and a specificity of 100% for identifying astrocytoma, with an area under the ROC curve (AUC) of 0.833.
Astrocytoma showed significantly higher T1, T2, and proton density values compared to oligodendroglioma (P< 0.0001, < 0.0001, and 0.0154, respectively). A T1 value cutoff of 1580 ms perfectly distinguished astrocytoma from oligodendroglioma, with an AUC of 1.00.
The study concluded that synthetic MRI provided better differentiation between astrocytoma and oligodendroglioma than conventional T2-FLAIR mismatch sign. Measuring T1 and T2 values with synthetic MRI could enhance the differentiation of IDH-mutant diffuse gliomas.
Open Access funding provided by Hiroshima University.
Source: https://link.springer.com/article/10.1007/s11060-024-04794-0
Onishi S, Yamasaki F, Akiyama Y, et al. (2024). “Usefulness of synthetic MRI for differentiation of IDH-mutant diffuse gliomas and its comparison with the T2-FLAIR mismatch sign.” J Neurooncol. 2024. https://doi.org/10.1007/s11060-024-04794-0
