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Research ArticleAdult Brain

Predicting Genotype and Survival in Glioma Using Standard Clinical MR Imaging Apparent Diffusion Coefficient Images: A Pilot Study from The Cancer Genome Atlas

C.-C. Wu, R. Jain, A. Radmanesh, L.M. Poisson, W.-Y. Guo, D. Zagzag, M. Snuderl, D.G. Placantonakis, J. Golfinos and A.S. Chi
American Journal of Neuroradiology October 2018, 39 (10) 1814-1820; DOI: https://doi.org/10.3174/ajnr.A5794
C.-C. Wu
aFrom the Department of Radiology (C.-C.W., W.-Y.G.), Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
bSchool of Medicine (C.-C.W., W.-Y.G.), National Yang-Ming University, Taipei, Taiwan, Republic of China
cDepartments of Radiology (C.-C.W., R.J., A.R.)
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R. Jain
cDepartments of Radiology (C.-C.W., R.J., A.R.)
dNeurosurgery (R.J., D.P., J.G.)
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A. Radmanesh
cDepartments of Radiology (C.-C.W., R.J., A.R.)
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L.M. Poisson
fDepartment of Public Health Sciences and Hermelin Brain Tumor Center (L.M.P.), Henry Ford Hospital, Detroit, Michigan
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W.-Y. Guo
aFrom the Department of Radiology (C.-C.W., W.-Y.G.), Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
bSchool of Medicine (C.-C.W., W.-Y.G.), National Yang-Ming University, Taipei, Taiwan, Republic of China
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D. Zagzag
ePathology (D.Z., M.S.), NYU School of Medicine, New York, New York
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M. Snuderl
ePathology (D.Z., M.S.), NYU School of Medicine, New York, New York
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D.G. Placantonakis
dNeurosurgery (R.J., D.P., J.G.)
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J. Golfinos
dNeurosurgery (R.J., D.P., J.G.)
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A.S. Chi
gNeuro-Oncology Program (A.S.C.), Laura and Isaac Perlmutter Cancer Center, NYU School of Medicine and Langone Health, New York, New York.
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    Fig 1.

    Boxplot representation of rADCmean values by glioma IDH genotype.

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    Fig 2.

    Kaplan-Meier survival curve subclassification for the present study by relative ADC and IDH genotype. Censored patients are annotated by a asterisks or plus signs. Results of the analysis are provided in Table 2. IDHmut indicates IDH-mutant; IDHwt, IDH wild-type.

Tables

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    Table 1:

    MR imaging features and IDH-mutation and 1p/19q codeletion status

    IDH Wild- TypeIDH-MutantPIDH-Mutant, Non-1p/19q CodeletedIDH-Mutant, 1p/19q CodeletedP
    MR imaging features (No.) (%)
        T2 signal intensitiesa
            >Gray matter13 (22.4%)30 (43.5%).012c21 (48.8%)9 (34.6%).248
            >Mixed45 (77.6%)39 (56.5%)22 (51.2%)17 (65.4%)
    T2 homogeneitya
        Homogeneous6 (10.3%)14 (20.3%).12510 (23.3%)4 (15.4%).544
        Heterogeneous52 (89.7%)55 (79.7%)33 (76.7%)22 (84.6%)
    Margin
        Well-defined32 (54.2%)27 (38.0%).06520 (44.4%)7 (26.9%).143
        Mixed27 (45.8%)44 (62.0%)25 (55.6%)19 (73.1%)
    Edema
        No-to-minimal20 (33.9%)57 (79.2%)<.001c38 (82.6%)19 (73.1%).339
        Mild-to-marked39 (66.1%)15 (20.8%)8 (17.4%)7 (26.9%)
    Enhancing patternb
        None/minimally enhancing4 (7.0%)30 (42.3%)<.001c19 (41.3%)11 (44.0%).826
        Enhancing55 (93.2%)41 (56.9%)27 (58.7%)14 (56.0%)
    Proportion of enhancing areab
        <50%14 (23.7%)63 (88.7%)<.001c40 (87.0%)23 (92.0%).704
        ≥50%45 (76.3%)8 (11.3%)6 (13.0%)2 (8.0%)
    Cystic area
        Presence5 (8.5%)28 (39.4%).013c26 (56.5%)17 (65.4%).461
        Absence54 (91.5%)43 (59.7%)20 (43.5%)9 (34.6%)
    Necrotic areab
        Presence49 (83.1%)16 (22.5%)<.001c38 (82.6%)17 (68.0%).159
        Absence10 (16.9%)55 (77.5%)8 (17.4%)8 (32.0%)
    rADCmean (median)1.11.6<.001c1.71.5.071
    rADCmin (median)0.91.4<.001c1.41.3.178
    rADCmax (median)1.31.8<.001c1.91.7.106
    • ↵a There were 4 cases lacking T2 MR images.

    • ↵b One case in the IDH-mutant group lacked postcontrast studies.

    • ↵c Statistically significant (P < .05).

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    Table 2:

    Comparison of overall survival by relative ADC and glioma IDH-mutation status

    VariableaCase No.Survival TimebCoefficient (β)P Value
    IDH mutant, high rADCmean6362.0
        vs IDH mutant, low rADCmean.141.003
        vs IDH wild-type, high rADCmean.06<.001
        vs IDH wild-type, low rADCmean.24<.001
    IDH mutant, low rADCmean924.2 (0.0–55.0)
        vs IDH wild-type, high rADCmean.45.614
    IDH wild-type, high rADCmean3017.7 (11.6–23.7)
        vs IDH wild-type, low rADCmean.25.041
    IDH wild-type, low rADCmean2910.4 (4.4–16.4)
        vs IDH mutant, low rADCmean.51.179
    • ↵a High rADCmean: rADCmean values ≥ 1.08; low rADCmean: rADCmean values < 1.08.

    • ↵b Survival time is expressed as median (95% CI) (months).

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American Journal of Neuroradiology: 39 (10)
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C.-C. Wu, R. Jain, A. Radmanesh, L.M. Poisson, W.-Y. Guo, D. Zagzag, M. Snuderl, D.G. Placantonakis, J. Golfinos, A.S. Chi
Predicting Genotype and Survival in Glioma Using Standard Clinical MR Imaging Apparent Diffusion Coefficient Images: A Pilot Study from The Cancer Genome Atlas
American Journal of Neuroradiology Oct 2018, 39 (10) 1814-1820; DOI: 10.3174/ajnr.A5794

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Predicting Genotype and Survival in Glioma Using Standard Clinical MR Imaging Apparent Diffusion Coefficient Images: A Pilot Study from The Cancer Genome Atlas
C.-C. Wu, R. Jain, A. Radmanesh, L.M. Poisson, W.-Y. Guo, D. Zagzag, M. Snuderl, D.G. Placantonakis, J. Golfinos, A.S. Chi
American Journal of Neuroradiology Oct 2018, 39 (10) 1814-1820; DOI: 10.3174/ajnr.A5794
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