The T2-FLAIR Mismatch Sign as an Imaging Indicator of IDH-Mutant, 1p/19q Non-Codeleted Lower Grade Gliomas: A Systematic Review and Diagnostic Accuracy Meta-Analysis

Adamou, Antonis; Beltsios, Eleftherios T.; Papanagiotou, Panagiotis

doi:10.3390/diagnostics11091620

Cited by 9 publications

(3 citation statements)

References 28 publications

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“…However, it has a low sensitivity of 42% [ 6 ]. Adamou et al study, showed the diagnostic accuracy for IDH mutant non-codeleted LGGs with specificity and sensitivity of 97% and 40%, respectively [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

T2-Fluid-Attenuated Inversion Recovery (FLAIR) Mismatch as a Novel Specific MRI Marker for Adult Low-Grade Glioma (LGG): A Case Report

Slaghour¹,

Almarshedi²,

Alzahrani³

et al. 2022

Cureus

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Astrocytic tumors are primary central nervous system tumors. They are the most common tumors arising from glial cells. In the new WHO classification 2021, adult-type diffuse astrocytic gliomas subdivide into isocitrate dehydrogenase (IDH)-mutant astrocytoma, IDH-mutant and 1p/19q-codeleted oligodendroglioma, and IDH-wildtype glioblastoma. The T2-fluid-attenuated inversion recovery (FLAIR) mismatch sign describes the MRI appearance of IDH-mutant astrocytoma, it is considered a highly specific radiogenomic signature for diffuse astrocytoma, as opposed to other lower-grade. MRI is the first and most accurate diagnostic tool for low-grade gliomas (LGGs). It is particularly helpful in distinguishing a diffuse astrocytoma from an oligodendroglioma that will not demonstrate T2-FLAIR mismatch. The tumor displays a hyperintense signal on T2-weighted images and a hypointense signal on T2-weighted FLAIR images, which distinguishes it from other types of diffuse gliomas. We report a case of a 29-year-old female patient who was diagnosed with IDH-mutant 1p/19q-non-codeleted diffuse astrocytoma based on MRI T-2 FLAIR mismatch sign, which is confirmed by the molecular analysis in the pathology lab. Our aim of this report is to confirm the power of the MRI findings in the diagnosis of glioma genotypes and to assess neurosurgeons in the preoperative surgical planning.

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Section: Discussionmentioning

confidence: 99%

T2-Fluid-Attenuated Inversion Recovery (FLAIR) Mismatch as a Novel Specific MRI Marker for Adult Low-Grade Glioma (LGG): A Case Report

Slaghour¹,

Almarshedi²,

Alzahrani³

et al. 2022

Cureus

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“…It has been shown that Haralick features derived from the T2WFLAIR sequence can predict the survival of patients with glioblastoma [11]. In addition, a T2WIFLAIR mismatch sign is being investigated, which can indicate the presence or absence of specific mutations [12].…”

Section: Texture-based Featuresmentioning

confidence: 99%

Radiomics in the diagnosis of glioblastoma

Kwiatkowska-Miernik,

Mruk,

Sklinda

et al. 2023

Pol J Radiol

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Radiomics is a process of extracting many quantitative data obtained from medical images and analysing them. In neuroradiology it may be used to discover magnetic resonance imaging (MRI) features of glioblastomas that are impossible to identify by human vision alone. In this article, the authors describe the methodology and their first experience in creating a predictive model based on radiomic features obtained from the preoperative MRI examination of patients with glioblastoma. Early identification of malignant glioblastoma subtypes characterized by different prognoses and responses to treatment would greatly facilitate the implementation of targeted therapy, which appears to be the future of glioblastoma treatment.

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“…However, it occasionally yields false positives in other tumor types and has notable false-negative results. Combining it with additional imaging parameters may enhance its diagnostic accuracy [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of MRI in Detecting 1p/19q Co-deletion Status of Gliomas: A Single-Center Retrospective Study

Naeem,

Aziz,

Nasir

et al. 2024

Cureus

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BackgroundOligodendrogliomas, rare brain tumors in the frontal lobe's white matter, are reshaped by molecular markers like isocitrate dehydrogenase mutations and 1p/19q co-deletion, influencing treatment outcomes. Despite the initial indolence, these tumors pose a significant risk, with a median survival of 10-12 years. Noninvasive alternatives, such as magnetic resonance imaging (MRI) for assessing T2-fluid-attenuated inversion recovery (FLAIR) mismatch and calcifications, provide insights into molecular subtypes and aid prognosis. Our study explored these features to predict the oligodendroglioma status and refine patient management to improve outcomes. MethodsIn this retrospective study, patient data identified patients with suspected central nervous system tumors undergoing MRI, revealing low-grade gliomas. Surgical biopsy and 1p/19q fluorescence in situ hybridization confirmed the co-deletion status. MRI was used to assess various morphological features. Statistical analyses included x2 tests, Fisher's exact tests, Kruskal-Wallis tests, and binary logistic regression models, with significance set at p < 0.05. ResultsSeventy-three patients (median age, 37 years) were stratified according to 1p/19q co-deletion. Most (61.6%) were 18-40 years old and mostly male (67.1%). Co-deletion cases, primarily frontal lobe lesions (67.6%), were unilateral (88.2%), with 55.9% non-circumscribed margins and 58.8% ill-defined contours. Smooth contrast enhancement and no necrosis were observed in 48.1% of 1p/19q co-deletion cases. Logistic regression analysis showed a significant association between ill-defined/irregular contours and 1p/19q co-deletion. Fisher's exact test confirmed this but raised concerns about the small sample size influencing the conclusions. ConclusionsThis study established a significant link between glioma tumor contour characteristics, particularly irregular and ill-defined contours, and the likelihood of 1p/19q co-deletion. Our findings underscore the clinical relevance of using tumor contours in treatment decisions and prognosis assessments.

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The T2-FLAIR Mismatch Sign as an Imaging Indicator of IDH-Mutant, 1p/19q Non-Codeleted Lower Grade Gliomas: A Systematic Review and Diagnostic Accuracy Meta-Analysis

Cited by 9 publications

References 28 publications

T2-Fluid-Attenuated Inversion Recovery (FLAIR) Mismatch as a Novel Specific MRI Marker for Adult Low-Grade Glioma (LGG): A Case Report

T2-Fluid-Attenuated Inversion Recovery (FLAIR) Mismatch as a Novel Specific MRI Marker for Adult Low-Grade Glioma (LGG): A Case Report

Radiomics in the diagnosis of glioblastoma

Accuracy of MRI in Detecting 1p/19q Co-deletion Status of Gliomas: A Single-Center Retrospective Study

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