Magnetic Resonance Imaging Derived Biomarkers of IDH Mutation Status and Overall Survival in Grade III Astrocytomas

• DOI: 10.3390/diagnostics10040247
• Publication Date: 2020-04-23T14:46:22Z
• Authors: Paola Feraco; Antonella Bacci; Patrizia Ferrazza; Luc van den Hauwe; Riccardo Pertile; Salvatore Girlando; Mattia Barbareschi; Cesare Gagliardo; Alessio Giuseppe ...; Benedetto Petralia
• Keywords: Medicine (General); Anaplastic astrocytomas; Apparent diffusion coefficient (ADC); Diffusion weighted imaging (DWI); Isocitrate dehydrogenase (IDH) mutation; Overall survival; Radiogenomics; overall survival; radiogenomics; Article; 03 medical and health sciences; R5-920; 0302 clinical medicine; isocitrate dehydrogenase (IDH) mutation; isocitrate dehydrogenase (IDH) mutation; diffusion weighted imaging (DWI); apparent diffusion coefficient (ADC); anaplastic astrocytomas; overall survival; radiogenomics; diffusion weighted imaging (DWI); Human medicine; apparent diffusion coefficient (ADC); anaplastic astrocytomas

The evaluation of the isocitrate dehydrogenase (IDH) mutation status in the glioma decision-making process has diagnostic, prognostic and therapeutic implications. The aim of this study was to evaluate whether conventional magnetic resonance imaging (MRI) and apparent diffusion coefficient (ADC) can noninvasively predict the most common IDH mutational status (R132H) in GIII-astrocytomas and the overall survival (OS). Hence, twenty-two patients (9-F, 13-M) with a histological diagnosis of GIII-astrocytoma and evaluation of IDH-mutation status (12-wild type, 10-mutant) were retrospectively evaluated. Imaging studies were reviewed for the morphological feature and mean ADC values (ADCm). Statistics included a Fisher’s exact test, Student’s t-test, Spearman’s Test and receiver operating characteristic analysis. A p ≤ 0.05 value was considered statistically significant for all the tests. A younger age and a frontal location were more likely related to mutational status. IDH-wild type (Wt) exhibited a slight enhancement (p = 0.039). The ADCm values in IDH-mutant (Mut) patients were higher than those of IDH-Wt patients (p < 0.0004). The value of ADC ≥ 0.99 × 10−3 mm2/s emerged as a “cut-off” to differentiate the mutation state. In the overall group, a positive relationship between the ADCm values and OS was detected (p = 0.003; r = 0.62). Adding quantitative measures of ADC values to conventional MR imaging could be used routinely as a noninvasive marker of specific molecular patterns.