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扩散张量成像能否无创检测星形胶质瘤中的异柠檬酸脱氢酶1(IDH1)基因突变?一项对112例病例的回顾性研究。

Can diffusion tensor imaging noninvasively detect IDH1 gene mutations in astrogliomas? A retrospective study of 112 cases.

作者信息

Tan W L, Huang W Y, Yin B, Xiong J, Wu J S, Geng D Y

机构信息

From the Departments of Radiology (W.L.T., W.Y.H., B.Y., D.Y.G.).

Neuropathology (J.S.X.).

出版信息

AJNR Am J Neuroradiol. 2014 May;35(5):920-7. doi: 10.3174/ajnr.A3803. Epub 2014 Feb 20.

Abstract

BACKGROUND AND PURPOSE

IDH1 mutational status probably plays an important role in the predictive response for patients with astroglioma. This study explores whether DTI metrics are able to noninvasively detect IDH1 status in astrogliomas.

MATERIALS AND METHODS

The DTI data of 112 patients with pathologically proven astroglioma (including 25, 12, and 10 cases with IDH1 mutation and 11, 11, and 43 cases without mutation in grades II, III, and IV, respectively) were retrospectively reviewed. The maximal fractional anisotropy, minimal ADC, ratio of maximal fractional anisotropy, and ratio of minimal ADC in the tumor body were measured. In the same World Health Organization grading, the imaging parameters of patients with and without IDH1 R132H mutation were compared by means of optimal metrics for detecting mutations. Receiver operating characteristic curve analysis was performed.

RESULTS

The maximal fractional anisotropy and ratio of maximal fractional anisotropy values had statistical significance between patients with IDH1 R132H mutation and those without mutation in astrogliomas of grades II and III. The areas under the curve for maximal fractional anisotropy and ratio of maximal fractional anisotropy were both 0.92 in grade II and 0.80 and 0.82 in grade III. The minimal ADC value and ratio of minimal ADC value also demonstrated statistical significance between patients with mutation and those without mutation in all astroglioma grades. The areas under the curve for minimal ADC were 0.94 (II), 0.76 (III), and 0.66 (IV), and the areas under the curve for ratio of minimal ADC were 0.93 (II), 0.83 (III), and 0.70 (IV).

CONCLUSIONS

Fractional anisotropy and ADC from DTI can noninvasively detect IDH1 R132H mutation in astrogliomas.

摘要

背景与目的

异柠檬酸脱氢酶1(IDH1)突变状态可能在星形胶质瘤患者的预测反应中起重要作用。本研究探讨扩散张量成像(DTI)指标是否能够无创检测星形胶质瘤中的IDH1状态。

材料与方法

回顾性分析112例经病理证实的星形胶质瘤患者的DTI数据(其中Ⅱ级、Ⅲ级和Ⅳ级分别有25例、12例和10例IDH1突变,无突变的分别为11例、11例和43例)。测量肿瘤体内的最大各向异性分数、最小表观扩散系数(ADC)、最大各向异性分数比值和最小ADC比值。在相同的世界卫生组织分级中,通过检测突变的最佳指标比较有和无IDH1 R132H突变患者的影像学参数。进行受试者操作特征曲线分析。

结果

在Ⅱ级和Ⅲ级星形胶质瘤中,IDH1 R132H突变患者与无突变患者之间的最大各向异性分数和最大各向异性分数比值具有统计学意义。Ⅱ级中最大各向异性分数和最大各向异性分数比值的曲线下面积均为0.92,Ⅲ级中分别为0.80和0.82。在所有星形胶质瘤分级中,最小ADC值和最小ADC值比值在有突变和无突变患者之间也显示出统计学意义。最小ADC的曲线下面积分别为0.94(Ⅱ级)、0.76(Ⅲ级)和0.66(Ⅳ级),最小ADC比值的曲线下面积分别为0.93(Ⅱ级)、0.83(Ⅲ级)和0.70(Ⅳ级)。

结论

DTI中的各向异性分数和ADC能够无创检测星形胶质瘤中的IDH1 R132H突变。

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