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MRI features predict tumor grade in isocitrate dehydrogenase (IDH)–mutant astrocytoma and oligodendroglioma

  • Diagnostic Neuroradiology
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Abstract

Purpose

Nearly all literature for predicting tumor grade in astrocytoma and oligodendroglioma pre-dates the molecular classification system. We investigated the association between contrast enhancement, ADC, and rCBV with tumor grade separately for IDH-mutant astrocytomas and molecularly-defined oligodendrogliomas.

Methods

For this retrospective study, 44 patients with IDH-mutant astrocytomas (WHO grades II, III, or IV) and 39 patients with oligodendrogliomas (IDH-mutant and 1p/19q codeleted) (WHO grade II or III) were enrolled. Two readers independently assessed preoperative MRI for contrast enhancement, ADC, and rCBV. Inter-reader agreement was calculated, and statistical associations between MRI metrics and WHO grade were determined per reader.

Results

For IDH-mutant astrocytomas, both readers found a stepwise positive association between contrast enhancement and WHO grade (Reader A: OR 7.79 [1.97, 30.80], p = 0.003; Reader B: OR 6.62 [1.70, 25.82], p = 0.006); both readers found that ADC was negatively associated with WHO grade (Reader A: OR 0.74 [0.61, 0.90], p = 0.002); Reader B: OR 0.80 [0.66, 0.96], p = 0.017), and both readers found that rCBV was positively associated with WHO grade (Reader A: OR 2.33 [1.35, 4.00], p = 0.002; Reader B: OR 2.13 [1.30, 3.57], p = 0.003). For oligodendrogliomas, both readers found a positive association between contrast enhancement and WHO grade (Reader A: OR 15.33 [2.56, 91.95], p = 0.003; Reader B: OR 20.00 [2.19, 182.45], p = 0.008), but neither reader found an association between ADC or rCBV and WHO grade.

Conclusions

Contrast enhancement predicts WHO grade for IDH-mutant astrocytomas and oligodendrogliomas. ADC and rCBV predict WHO grade for IDH-mutant astrocytomas, but not for oligodendrogliomas.

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Funding

No funds, grants, or other support was received

The authors have no relevant financial or non-financial interests to disclose.

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Authors and Affiliations

  1. Department of Radiology and Medical Imaging, University of Virginia Health System, Box 800170, Charlottesville, VA, 22908, USA

    David A. Joyner, John Garrett, Prem P. Batchala, Bharath Rama, Joshua R. Ravicz & Sohil H. Patel

  2. Department of Public Health Sciences, University of Virginia Health System, Charlottesville, VA, USA

    James T. Patrie

  3. Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA

    Maria-B. Lopes

  4. Division of Neuro-Oncology, University of Virginia Health System, Charlottesville, VA, USA

    Camilo E. Fadul & David Schiff

  5. Departments of Radiology and Neurosurgery, New York University Grossman School of Medicine, New York, NY, USA

    Rajan Jain

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  1. David A. Joyner
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Contributions

David Joyner: study design, implementation, data collection, interpretation, manuscript draft, and revisions

John Garrett: data collection, manuscript draft, and revisions

Prem Batchala: data interpretation, manuscript draft, and revisions

Bharath Rama: manuscript draft and revisions

Joshua Ravicz: manuscript draft and revisions

James Patrie: statistical analysis, interpretation, manuscript draft, and revisions

Maria-B. Lopes: interpretation, manuscript draft, and revisions

Camilo Fadul: interpretation, manuscript draft, and revisions

David Schiff: interpretation, manuscript draft, and revisions

Rajan Jain: interpretation, manuscript draft, and revisions

Sohil Patel: study design, implementation, data collection, interpretation, manuscript draft, and revisions

All the authors have read and approved the final version of the manuscript.

Corresponding author

Correspondence to Sohil H. Patel.

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This research study was conducted retrospectively from data obtained for clinical purposes, in accordance with the guidelines of the institutional IRB. The requirement for informed consent was waived by our IRB.

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Joyner, D.A., Garrett, J., Batchala, P.P. et al. MRI features predict tumor grade in isocitrate dehydrogenase (IDH)–mutant astrocytoma and oligodendroglioma. Neuroradiology 65, 121–129 (2023). https://doi.org/10.1007/s00234-022-03038-0

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