Predicting Genotype and Survival in Glioma Using Standard Clinical MR Imaging Apparent Diffusion Coefficient Images: A Pilot Study from The Cancer Genome Atlas.

BACKGROUND AND PURPOSE

Few studies have shown MR imaging features and ADC correlating with molecular markers and survival in patients with glioma. Our purpose was to correlate MR imaging features and ADC with molecular subtyping and survival in adult diffuse gliomas.

MATERIALS AND METHODS

Presurgical MRIs and ADC maps of 131 patients with diffuse gliomas and available molecular and survival data from The Cancer Genome Atlas were reviewed. MR imaging features, ADC (obtained by ROIs within the lowest ADC area), and mean relative ADC values were evaluated to predict () mutation, 1p/19q codeletion status, promoter methylation, and overall survival.

RESULTS

wild-type gliomas tended to exhibit enhancement, necrosis, and edema; >50% enhancing area ( < .001); absence of a cystic area ( = .013); and lower mean relative ADC (median, 1.1 versus 1.6; < .001) than -mutant gliomas. By means of a cutoff value of 1.08 for mean relative ADC, -mutant and wild-type gliomas with lower mean relative ADC (<1.08) had poorer survival than those with higher mean relative ADC (median survival time, 24.2 months; 95% CI, 0.0-54.9 months versus 62.0 months; = .003; and median survival time, 10.4 months; 95% CI, 4.4-16.4 months versus 17.7 months; 95% CI, 11.6-23.7 months; = .041, respectively), regardless of World Health Organization grade. Median survival of those with -mutant glioma with low mean relative ADC was not significantly different from that in those with wild-type glioma. Other MR imaging features were not statistically significant predictors of survival.

CONCLUSIONS

wild-type glioma showed lower ADC values, which also correlated with poor survival in both -mutant and wild-type gliomas, irrespective of histologic grade. A subgroup with -mutant gliomas with lower ADC had dismal survival similar to that of those with wild-type gliomas.