Article Figures & Data
Figures
- Fig 1.
A 52-year-old woman with a diffuse astrocytoma without IDH mutation. A, Axial T2WI demonstrates heterogeneous high signal intensity with indistinct borders on the left temporal lobe. B, Contrast-enhanced axial T1-weighted image demonstrates a lesion enhancement with blurred borders. C, A corresponding ADC map shows the tumor with a decreased ADC value (ADCmin = 0.684 × 10−3 mm2/s, rADC = 1.08). D, Correlative color CBV image shows elevated perfusion with the calculated rCBVmax of 3.10.
- Fig 2.
A 50-year-old man with an anaplastic astrocytoma with an IDH mutation. A, Axial T2WI demonstrates heterogeneous high signal intensity with sharp borders on the right temporal lobe. B, Contrast-enhanced axial T1-weighted image demonstrates a nonenhancing lesion in the right temporal region. C, A corresponding ADC map shows the tumor with an increased ADC value (ADCmin = 1.456 × 10−3mm2/s, rADC = 2.51). D, Correlative color CBV image shows relatively low perfusion with the calculated rCBVmax of 1.86.
- Fig 3.
Comparison of receiver operating characteristic curves of ADCmin, rADC, rCBVmax (A) and cMRI, DWI + DSC-PWI, and cMRI + DWI + DSC-PWI (B) in differentiating IDH-mutant grade II and III astrocytomas from wild types.
Tables
- Table 1:
The main clinical and cMRI features of IDH mutational status in grade II and III astrocytomasa
IDH Mutation (n = 17) IDH Wild Type (n = 25) P Value Sex (male/female) 9/8 17/8 .157 Age (yr) 35.76 ± 9.13 45.96 ± 18.36 .041 Location .006 Frontal lobe 9 (52.9%) 4 (16.0%) Parietal lobe 1 (5.9%) 3 (12.0%) Temporal lobe 6 (35.3%) 4 (16.0%) Occipital lobe 0 0 Insular lobe 1 (5.9%) 3 (12.0%) Others 0 11 (44.0%) Homogeneity .439 Homogeneous 4 (23.5%) 7 (28.0%) Heterogeneous 13 (76.5%) 18 (72.0%) Edema .746 Presence 3 (17.6%) 7 (28.0%) Absence 14 (82.4%) 18 (72.0%) Borders .037 Sharp 11 (64.7%) 8 (32.0%) Indistinct 6 (35.3%) 17 (68.0%) Contrast enhancement .286 No 11 (64.7%) 12 (48.0%) Yes 6 (35.3%) 13 (54.0%) Histology .051 Grade II astrocytomas 12 (70.6%) 12 (48.0%) Grade III astrocytomas 5 (29.4%) 13 (54.0%) ↵a Data are number (%) unless otherwise indicated.
- Table 2:
Comparison of DWI and DSC-PWI variables between IDH mutation and wild-type grade II and III astrocytomas
IDH Mutation IDH Wild Type P Value ADCmin (×10−3 mm2/s) 1.21 ± 0.27 0.87 ± 0.18 <.001 rADC 1.88 ± 0.41 1.37 ± 0.31 <.001 rCBVmax 1.41 ± 0.50 3.47 ± 2.34 .004 a Data are means.
- Table 3:
Measurement of TV, sensitivity, specificity, PPV, NPV, YI, and AUC of ADCmin values, rADC, rCBVmax, cMRI, DWI + DSC-PWI, and cMRI+ DWI + DSC-PWI for assessing the IDH status of grade II and III astrocytomas
TV Sensitivity (%) Specificity (%) PPV (%) NPV (%) YI AUC (95% CI) ADCmin 1.01 76.92 82.61 91.20 60.50 0.60 0.87 (0.71–0.96) rADC 1.60 84.62 73.91 88.30 67.30 0.59 0.84 (0.68–0.94) rCBVmax 2.35 100.00 60.87 85.60 100.00 0.61 0.82 (0.66–0.93) cMRI 88.24 52.00 88.50 44.30 0.40 0.78 (0.63–0.89) DWI + DSC-PWI 100.00 65.22 87.00 100.00 0.65 0.88 (0.54–0.84) cMRI+ DWI + DWI-PWI 92.31 91.30 96.10 83.60 0.84 0.92 (0.78–0.98) Note:—TV indicates threshold values; PPV, positive predictive value; NPV, negative predictive value; YI, Youden Index; AUC, area under the curve.
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