■分子标记的评估(IDH,pTERT,1p/19q共同删除,和MGMT)在成人弥漫性胶质瘤中对于准确诊断和最佳治疗计划至关重要。动态敏感性对比(DSC)和动脉自旋标记(ASL)灌注MRI技术在分子标志物分类方面均显示出良好的性能,然而,他们的表现没有被并排比较。
■90例诊断为弥漫性神经胶质瘤的患者的治疗前MRI数据(男性54例/女性36例,53.1±15.5年,2-4级)进行回顾性分析。在具有可用IDH突变(n=67)的患者中,分析了DSC衍生的归一化脑血流量/体积(nCBF/nCBV)和ASL衍生的nCBF在肿瘤和局灶性水肿中的表达。pTERT突变(n=39),1p/19q共缺失(n=33),MGMT启动子甲基化状态(n=31)。交叉验证的单和多变量逻辑回归模型评估了分子标记检测中灌注参数的性能。
■肿瘤和水肿中的ASL和DSC灌注参数将IDH-野生型(wt)和pTERT-wt肿瘤与突变的肿瘤区分开。对于IDH(最大AUROCC分别为0.82和0.83)和pTERT(最大AUROCC分别为0.70和0.81)状态分化的ASL-nCBF和DSC-nCBV,单变量分类性能相当。多变量方法改进了IDH(DSC-nCBVAUROCC0.89)和pTERT(ASL-nCBFAUROCC0.8和DSC-nCBVAUROCC0.86)分类。然而,ASL和DSC参数不能区分1p/19q共缺失或MGMT启动子甲基化状态。ASL-nCBF与DSC-nCBV/-nCBF在肿瘤和水肿中呈正相关。
■ASL是一种可行的无钆的DSC替代品,用于成人弥漫性神经胶质瘤的分子表征。
UNASSIGNED: Evaluation of molecular markers (IDH, pTERT, 1p/19q codeletion, and MGMT) in adult diffuse gliomas is crucial for accurate diagnosis and optimal treatment planning. Dynamic Susceptibility Contrast (DSC) and Arterial Spin Labeling (
ASL) perfusion MRI techniques have both shown good performance in classifying molecular markers, however, their performance has not been compared side-by-side.
UNASSIGNED: Pretreatment MRI data from 90 patients diagnosed with diffuse glioma (54 men/36 female, 53.1 ± 15.5 years, grades 2-4) were retrospectively analyzed. DSC-derived normalized cerebral blood flow/volume (nCBF/nCBV) and
ASL-derived nCBF in tumor and perifocal edema were analyzed in patients with available IDH-mutation (n = 67), pTERT-mutation (n = 39), 1p/19q codeletion (n = 33), and MGMT promoter methylation (n = 31) status. Cross-validated uni- and multivariate logistic regression models assessed perfusion parameters\' performance in molecular marker detection.
UNASSIGNED: ASL and DSC perfusion parameters in tumor and edema distinguished IDH-wildtype (wt) and pTERT-wt tumors from mutated ones. Univariate classification performance was comparable for
ASL-nCBF and DSC-nCBV in IDH (maximum AUROCC 0.82 and 0.83, respectively) and pTERT (maximum AUROCC 0.70 and 0.81, respectively) status differentiation. The multivariate approach improved IDH (DSC-nCBV AUROCC 0.89) and pTERT (ASL-nCBF AUROCC 0.8 and DSC-nCBV AUROCC 0.86) classification. However, ASL and DSC parameters could not differentiate 1p/19q codeletion or MGMT promoter methylation status. Positive correlations were found between
ASL-nCBF and DSC-nCBV/-nCBF in tumor and edema.
UNASSIGNED: ASL is a viable gadolinium-free replacement for DSC for molecular characterization of adult diffuse gliomas.