利用影像特征评估胶质瘤患者异柠檬酸脱氢酶突变状态的可预测性。

Assessing the predictability of isocitrate dehydrogenase mutational status in glioma patients using imaging features.

作者信息

Goncalves Joao Meira, Miranda André, Silva Carolina, Carvalho Bruno, Polónia Patricia, Linhares Paulo

机构信息

Department of Neurosurgery, São João University Hospital, Porto, Portugal.

Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, Porto, Portugal.

出版信息

Surg Neurol Int. 2025 Jun 20;16:256. doi: 10.25259/SNI_323_2025. eCollection 2025.

Abstract

BACKGROUND

Radiogenomics, the intersection of imaging and genetics, is important in improving glioma diagnosis and treatment. This study aims to correlate imaging features with isocitrate dehydrogenase (IDH) mutation status, providing a non-invasive diagnostic tool to identify the genetic background of gliomas.

METHODS

In a retrospective sample of 59 patients with either IDH wild-type (WT) or IDH mutant gliomas, the study employed volumetric and morphologic magnetic resonance imaging (MRI) analyses to discern molecular alterations based on radiographic signatures. Key imaging biomarkers, such as the T2/fluid-attenuated inversion recovery mismatch, contrast enhancement patterns, and diffusion/perfusion metrics, were evaluated for their ability to differentiate between IDH-WT and mutant gliomas. Receiver operating characteristic curves were employed to evaluate diagnostic performance, and a logistic regression model was developed for patient classification based on imaging.

RESULTS

The results revealed that IDH mutant gliomas frequently exhibited distinct imaging characteristics, such as homogenous hyperintense T2 signals and absence of contrast enhancement. In addition, perfusion and diffusion metrics varied significantly between the IDH-WT and mutant groups, offering potential radiogenomic markers. A logistic regression model was developed to predict IDH status with high accuracy, identifying factors such as tumor enhancement size, presence of central necrosis, peritumoral edema, and patient age.

CONCLUSION

The study's results affirm the significance of radiogenomic correlations in predicting IDH status, resonating findings from prior research. We highlight the necessity of a multimodal approach in MRI analysis to enhance the non-invasive diagnostic accuracy for glioma patients.

摘要

背景

放射基因组学作为影像学与遗传学的交叉领域,在改善胶质瘤的诊断和治疗方面具有重要意义。本研究旨在将影像学特征与异柠檬酸脱氢酶(IDH)突变状态相关联,提供一种非侵入性诊断工具以识别胶质瘤的基因背景。

方法

在一项对59例IDH野生型(WT)或IDH突变型胶质瘤患者的回顾性研究中,该研究采用容积和形态磁共振成像(MRI)分析,以基于影像学特征辨别分子改变。评估了关键影像学生物标志物,如T2/液体衰减反转恢复不匹配、对比增强模式以及扩散/灌注指标,以确定它们区分IDH-WT和突变型胶质瘤的能力。采用受试者工作特征曲线评估诊断性能,并基于影像学建立了用于患者分类的逻辑回归模型。

结果

结果显示,IDH突变型胶质瘤常表现出独特的影像学特征,如T2信号均匀高强化且无对比增强。此外,IDH-WT组和突变组之间的灌注和扩散指标差异显著,提供了潜在的放射基因组学标志物。建立了一个逻辑回归模型以高精度预测IDH状态,确定了诸如肿瘤强化大小、中央坏死的存在、瘤周水肿和患者年龄等因素。

结论

该研究结果证实了放射基因组学相关性在预测IDH状态方面的重要性,与先前研究结果一致。我们强调在MRI分析中采用多模态方法以提高胶质瘤患者非侵入性诊断准确性的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5d1/12255178/34896568bd95/SNI-16-256-g001.jpg

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