■术前准确鉴定异柠檬酸脱氢酶(IDH)基因型和肿瘤亚型对于胶质瘤患者的正确治疗计划和预后评估非常重要。本研究旨在使用定量敏感性映射(QSM)和表观扩散系数(ADC)的直方图特征来区分成人型弥漫性神经胶质瘤的IDH基因型和肿瘤亚型。
■这项前瞻性研究在2019年3月至2022年1月之间随机招募了疑似神经胶质瘤的患者。从肿瘤实质中提取QSM和ADC的直方图特征。Mann-WhitneyU检验用于比较不同IDH基因型之间和肿瘤亚型之间的直方图特征差异。构建受试者工作特征(ROC)曲线以评估相应的诊断性能。
■本研究包括47例经组织病理学证实为成人型弥漫性神经胶质瘤的患者。总共七个QSM功能,包括10%(P10),第90百分位数(P90),四分位数间距(IQR),最大值,平均绝对偏差(MAD),均方根(RMS),和方差,和五个ADC功能,包括P10,平均,中位数,RMS,和偏度在不同IDH基因型之间表现出显著差异(均P<0.05),QSM的IQR显示最高的曲线下面积(AUC)为0.774[95%置信区间(CI):0.635-0.913]。为了分离肿瘤亚型,QSM的IQR还显示,胶质母细胞瘤(GBM)与星形细胞瘤的AUC最高为0.745(95%CI:0.566-0.924),GBM与少突胶质细胞瘤的AUC最高为0.848(95%CI:0.706-0.989),但是这些特征都不能区分星形细胞瘤和少突胶质细胞瘤。QSM的IQR的组合,ADC的P10,年龄达到IDH基因型的最高AUC为0.910(95%CI:0.826-0.994),GBM与星形细胞瘤和GBM与少突胶质细胞瘤的0.939(95%CI:0.859-1.000)和0.967(95%CI:0.904-1.000),分别。
■QSM和ADC直方图特征可作为非侵入性评估成人型弥漫性神经胶质瘤的IDH基因型和肿瘤亚型的潜在成像标志物。组合显著的特征可以显著增强诊断性能。
UNASSIGNED: Accurate preoperative identification of isocitrate dehydrogenase (IDH) genotypes and tumor subtypes is highly important for proper treatment planning and prognosis evaluation in patients with glioma. This study aimed to differentiate IDH genotypes and tumor subtypes of adult-type diffuse gliomas using histogram features of quantitative susceptibility mapping (QSM) and apparent diffusion coefficient (ADC).
UNASSIGNED: This prospective study enrolled patients with suspected gliomas between March 2019 and January 2022 in a random series. Histogram features of QSM and ADC were extracted from the tumor parenchyma. The Mann-Whitney U test was used to compare the difference in histogram features between different IDH genotypes and among tumor subtypes. Receiver operating characteristic (ROC) curves were constructed to assess the corresponding diagnostic performance.
UNASSIGNED: This study included 47 patients with histopathologically confirmed adult-type diffuse gliomas. Totals of seven QSM features including 10th percentile (P10), 90th percentile (P90), interquartile range (IQR), maximum, mean absolute deviation (MAD), root mean squared (RMS), and variance, and five ADC features including P10, mean, median, RMS, and skewness exhibited significant differences between different IDH genotypes (P<0.05 for all), with the IQR of QSM demonstrating the highest area under curve (AUC) of 0.774 [95% confidence interval (CI): 0.635-0.913]. For separating tumor subtypes, the IQR of QSM also showed the highest AUC of 0.745 (95% CI: 0.566-0.924) for glioblastoma (GBM) versus astrocytoma and 0.848 (95% CI: 0.706-0.989) for GBM versus oligodendroglioma, but none of the features could discriminate astrocytoma from oligodendroglioma. The combination of the IQR of QSM, P10 of ADC, and age achieved the highest AUC of 0.910 (95% CI: 0.826-0.994) for IDH genotypes, and 0.939 (95% CI: 0.859-1.000) and 0.967 (95% CI: 0.904-1.000) for GBM versus astrocytoma and GBM versus oligodendroglioma, respectively.
UNASSIGNED: QSM and ADC histogram features may serve as potential imaging markers for noninvasively assessing IDH genotypes and tumor subtypes of adult-type diffuse gliomas. Combining significant features may enhance the diagnostic performance substantially.