S C Thust1,2,3, J A Maynard4,2, M Benenati2,5, S J Wastling4,2, L Mancini4,2, Z Jaunmuktane6, S Brandner7, H R Jäger4,2,3. 1. From the Neuroradiological Academic Unit (S.C.T., J.A.M, S.J.W., L.M., H.R.J.), Department of Brain, Repair and Rehabilitation, UCL Institute of Neurology, London, UK s.thust@ucl.ac.uk. 2. Lysholm Department of Neuroradiology (S.C.T., J.A.M., M.B., S.J.W., L.M., H.R.J.), National Hospital for Neurology and Neurosurgery, London, UK. 3. Imaging Department (S.C.T., H.R.J.), University College London Foundation Hospital, London, UK. 4. From the Neuroradiological Academic Unit (S.C.T., J.A.M, S.J.W., L.M., H.R.J.), Department of Brain, Repair and Rehabilitation, UCL Institute of Neurology, London, UK. 5. Dipartimento di Diagnostica per Immagini (M.B.), Radioterapia, Oncologia ed Ematologia, Fondazione Policlinico Universitario A. Gemelli Institute for Research, Hospitalization and Health Care, Rome, Italy. 6. Department of Clinical and Movement Neurosciences (Z.J.). 7. Neurodegenerative Disease (S.B.), UCL Queen Square Institute of Neurology, and Division of Neuropathology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.
Abstract
BACKGROUND AND PURPOSE: Studies consistently report lower ADC values in isocitrate dehydrogenase (IDH) wild-type gliomas than in IDH mutant tumors, but their methods and thresholds vary. This research aimed to compare volumetric and regional ADC measurement techniques for glioma genotyping, with a focus on IDH status prediction. MATERIALS AND METHODS: Treatment-naïve World Health Organization grade II and III gliomas were analyzed by 3 neuroradiologist readers blinded to tissue results. ADC minimum and mean ROIs were defined in tumor and in normal-appearing white matter to calculate normalized values. T2-weighted tumor VOIs were registered to ADC maps with histogram parameters (mean, 2nd and 5th percentiles) extracted. Nonparametric testing (eta2 and ANOVA) was performed to identify associations between ADC metrics and glioma genotypes. Logistic regression was used to probe the ability of VOI and ROI metrics to predict IDH status. RESULTS: The study included 283 patients with 79 IDH wild-type and 204 IDH mutant gliomas. Across the study population, IDH status was most accurately predicted by ROI mean normalized ADC and VOI mean normalized ADC, with areas under the curve of 0.83 and 0.82, respectively. The results for ROI-based genotyping of nonenhancing and solid-patchy enhancing gliomas were comparable with volumetric parameters (area under the curve = 0.81-0.84). In rim-enhancing, centrally necrotic tumors (n = 23), only volumetric measurements were predictive (0.90). CONCLUSIONS: Regional normalized mean ADC measurements are noninferior to volumetric segmentation for defining solid glioma IDH status. Partially necrotic, rim-enhancing tumors are unsuitable for ROI assessment and may benefit from volumetric ADC quantification.
BACKGROUND AND PURPOSE: Studies consistently report lower ADC values in isocitrate dehydrogenase (IDH) wild-type gliomas than in IDH mutant tumors, but their methods and thresholds vary. This research aimed to compare volumetric and regional ADC measurement techniques for glioma genotyping, with a focus on IDH status prediction. MATERIALS AND METHODS: Treatment-naïve World Health Organization grade II and III gliomas were analyzed by 3 neuroradiologist readers blinded to tissue results. ADC minimum and mean ROIs were defined in tumor and in normal-appearing white matter to calculate normalized values. T2-weighted tumor VOIs were registered to ADC maps with histogram parameters (mean, 2nd and 5th percentiles) extracted. Nonparametric testing (eta2 and ANOVA) was performed to identify associations between ADC metrics and glioma genotypes. Logistic regression was used to probe the ability of VOI and ROI metrics to predict IDH status. RESULTS: The study included 283 patients with 79 IDH wild-type and 204 IDH mutant gliomas. Across the study population, IDH status was most accurately predicted by ROI mean normalized ADC and VOI mean normalized ADC, with areas under the curve of 0.83 and 0.82, respectively. The results for ROI-based genotyping of nonenhancing and solid-patchy enhancing gliomas were comparable with volumetric parameters (area under the curve = 0.81-0.84). In rim-enhancing, centrally necrotic tumors (n = 23), only volumetric measurements were predictive (0.90). CONCLUSIONS: Regional normalized mean ADC measurements are noninferior to volumetric segmentation for defining solid glioma IDH status. Partially necrotic, rim-enhancing tumors are unsuitable for ROI assessment and may benefit from volumetric ADC quantification.
Authors: C Mircea S Tesileanu; Linda Dirven; Maarten M J Wijnenga; Johan A F Koekkoek; Arnaud J P E Vincent; Hendrikus J Dubbink; Peggy N Atmodimedjo; Johan M Kros; Sjoerd G van Duinen; Marion Smits; Martin J B Taphoorn; Pim J French; Martin J van den Bent Journal: Neuro Oncol Date: 2020-04-15 Impact factor: 12.300
Authors: D R Johnson; F E Diehn; C Giannini; R B Jenkins; S M Jenkins; I F Parney; T J Kaufmann Journal: AJNR Am J Neuroradiol Date: 2017-01-26 Impact factor: 3.825
Authors: Maarten M J Wijnenga; Pim J French; Hendrikus J Dubbink; Winand N M Dinjens; Peggy N Atmodimedjo; Johan M Kros; Marion Smits; Renske Gahrmann; Geert-Jan Rutten; Jeroen B Verheul; Ruth Fleischeuer; Clemens M F Dirven; Arnaud J P E Vincent; Martin J van den Bent Journal: Neuro Oncol Date: 2018-01-10 Impact factor: 12.300
Authors: Matthew Grech-Sollars; Patrick W Hales; Keiko Miyazaki; Felix Raschke; Daniel Rodriguez; Martin Wilson; Simrandip K Gill; Tina Banks; Dawn E Saunders; Jonathan D Clayden; Matt N Gwilliam; Thomas R Barrick; Paul S Morgan; Nigel P Davies; James Rossiter; Dorothee P Auer; Richard Grundy; Martin O Leach; Franklyn A Howe; Andrew C Peet; Chris A Clark Journal: NMR Biomed Date: 2015-04 Impact factor: 4.044