IDH genotypes differentiation in glioblastomas using DWI and DSC-PWI in the enhancing and peri-enhancing region

摘要

Background Isocitrate dehydrogenase (IDH) mutation has diagnostic and prognostic values in glioblastomas. Peritumoral invasion of glioma cells is a cardinal feature of glioblastomas. Purpose To evaluate the contribution of DWI and DSC-PWI in the enhancing and peri-enhancing region for discriminating glioblastomas IDH genotypes, and the diagnostic values of combining two techniques in the peri-enhancing region compared with those in the enhancing region. Material and Methods We retrospectively reviewed the conventional MRI (cMRI), DWI and DSC-PWI obtained from 10 patients with IDH-mutated (IDH-m) glioblastomas and 65 patients with IDH wild-type (IDH-w) glioblastomas. Features of cMRI, relative minimum ADC in the enhancing region (rADC(min-t)) and peri-enhancing area (rADC(min-p)), and relative maximum CBV values in the enhancing region (rCBV(max-t)) and peri-enhancing region (rCBV(max-p)) were compared between two groups. Receiver operating characteristic curves and logistic regression analysis were used to assess diagnostic performance. Results IDH-m glioblastomas tended to present in frontal lobes and younger patients. The rADC(min-t) (P = 0.042) were significantly lower in IDH-w than IDH-m. Both rCBV(max-t) and rCBV(max-p) showed significant differences between two subgroups (all P 0.98 for rADC(min-t), <7.27 for rCBV(max-t), and < 0.97 for rCBV(max-p). Multivariate logistic regression revealed that the combination of rADC(min-t) and rCBV(max-t) yielded the highest sensitivity and specificity. Conclusion The rCBV(max-t) or rCBV(max-p) may serve as preferable and comparable imaging biomarkers for evaluation of glioblastomas IDH status. The combination of rADC(min-t) and rCBV(max-t) may yield the maximum predictive power for differentiating IDH status.