Departments of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010059, China; Inner Mongolia Medical University, Hohhot, China.
Departments of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010059, China.
Acad Radiol. 2023 Jul;30(7):1238-1246. doi: 10.1016/j.acra.2022.10.009. Epub 2022 Nov 5.
Currently, there is no noninvasive method to effectively judge the genotype of diffuse gliomas. We explored the association between mean apparent propagator-MRI (MAP-MRI) and WHO grade 2/3, IDH 1/2 mutations, and chromosome 1p/19q combined deletion genotypes in adult-type diffuse gliomas and compared it with the diagnostic efficiency of diffusion tensor imaging (DTI) and diffusional kurtosis imaging (DKI).
We prospectively recruited 67 participantshistopathologically diagnosed with adult-type diffuse gliomas. Routine MRI, DKI, and DSI were performed before surgery. The extreme and average partial diffusion indexes of solid tumors were measured. A comprehensive assessment of statistically significant diffusion parameters was performed after Bonferroni correction, including ROC curves, correct classification percentage (CCP), integrated discrimination improvement (IDI), net reclassification improvement (NRI), and k-fold cross validation.
For differentiating WHO grade 2/3, q-space inverse variance (QIV), mean kurtosis (MK), non-Gaussianity (NG), and return to the origin probability (RTOP) were different (p' < .05), with the mean QIV exhibiting the best diagnostic efficacy and stability (AUC = 0.973, CCP = 0.906). We observed significant differences in mean diffusivity (MD), mean square displacement, QIV, MK, and RTOP between the IDH wild-type and IDH mutant groups (p' < .001) (AUC, 0.806-0.978) and MAP-MRI showed a higher IDI than DTI and DKI (0.094-0.435, NRI > 0, respectively). For the chromosome 1p/19q combined deletion, the minimum QIV was different between the overall (p' < .05) and no significant differences in MD and MK was observed.
MAP-MRI effectively predicts the WHO grade 2/3, IDH 1/2 mutations, and chromosome 1p/19q combined deletion in adult-type diffuse gliomas, and it may perform better than DTI and DKT.
目前，尚无有效的无创方法来准确判断弥漫性神经胶质瘤的基因型。本研究旨在探讨平均表观扩散系数-MRI（MAP-MRI）与成人弥漫性神经胶质瘤的 WHO 分级 2/3、IDH1/2 突变和 1p/19q 联合缺失基因型之间的相关性，并将其与弥散张量成像（DTI）和弥散峰度成像（DKI）的诊断效能进行比较。
前瞻性纳入 67 例经组织病理学诊断为成人弥漫性神经胶质瘤的患者，所有患者术前均行常规 MRI、DKI 和 DSI 检查。测量实体肿瘤的极端和平均部分扩散指数。对经过 Bonferroni 校正的具有统计学意义的扩散参数进行全面评估，包括 ROC 曲线、正确分类百分比（CCP）、综合判别改善（IDI）、净再分类改善（NRI）和 k 折交叉验证。
在区分 WHO 分级 2/3 方面，q-空间倒数方差（QIV）、平均峰度（MK）、非高斯性（NG）和原点回归概率（RTOP）存在差异（p'＜0.05），平均 QIV 的诊断效能和稳定性最佳（AUC=0.973，CCP=0.906）。IDH 野生型和突变型组之间的平均扩散系数（MD）、均方根位移、QIV、MK 和 RTOP 存在显著差异（p'＜0.001）（AUC：0.806-0.978），MAP-MRI 的 IDI 高于 DTI 和 DKI（0.094-0.435，NRI＞0）。对于 1p/19q 联合缺失，总组间最小 QIV 存在差异（p'＜0.05），MD 和 MK 无显著差异。
MAP-MRI 可有效预测成人弥漫性神经胶质瘤的 WHO 分级 2/3、IDH1/2 突变和 1p/19q 联合缺失，其诊断效能可能优于 DTI 和 DKI。
