Associating IDH and TERT Mutations in Glioma with Diffusion Anisotropy in Normal-Appearing White Matter

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FIG 1.
Patient-selection flowchart.
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FIG 2.
NAWM segmentations and masks. T2WI (A), semiautomatic NAWM boundary demarcations overlaid on T2WI (B), the coregistered B₀ image (C), NAWM boundary demarcations on the coregistered B₀ image (D), total NAWM mask on T2WI (E), on B₀ image (F), and the corresponding right (G) and left (H) hemisphere masks.
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FIG 3.
Boxplots of WB-NAWM means of ADC, λ₁, RD, λ₂, λ₃, FA, and RA grouped by IDH-TERT subgroups (A), IDH mutation (B), and TERT (C) mutation statuses, respectively. The asterisk indicates P < .05, and double asterisks indicate P < .008 according to the Bonferroni correction for multiple-comparison analysis. The plus sign indicates outlier values, whiskers indicate minimum and maximum values, the box limits are 25th and 75th percentiles, and the midline shows the median. Neg. indicates negative; pos., positive.
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FIG 4.
Boxplots of HMeD (contralateral-ipsilateral) of ADC, λ₁, RD, λ₂, λ₃, FA, and RA grouped by IDH-TERT subgroups (A), IDH mutation (B), and TERT mutation (C) statuses, respectively. Fig 3 and Fig 4 legends are the same.

Table 1:

Cohort characteristics

Table 2:

Comparison of WB-NAWM means and HMeD of diffusion parameters for IDH-TERT molecular subgroups

	ADC	λ₁ (AD)	RD	λ₂	λ₃	FA	RA
IDH-TERT subgroup Kruskal-Wallis test P values
WB–NAWM	.10	.03^{^a}	.01^{^a}	.01^{^a}	.01^{^a}	.001^{^a}	.001^{^a}
HMeD	.10	.01^{^a}	.04^{^a}	.044^{^a}	.02^{^a}	<.001^{^a}	<.001^{^a}
IDH-TERT subgroup multiple comparisons P values
WB-NAWM
DN vs IDHonly	–	.59	.64	.61	.74	.52	.58
DN vs TERTonly	–	.99	.87	.88	.86	.82	.77
DN vs DP	–	.70	.82	.91	.79	.68	.69
IDHonly vs TERTonly	–	.04^{^a}	.01^{^b}	.007^{^b}	.01^{^a}	.002^{^b}	.002^{^b}
IDHonly vs DP	–	>.99	>.99	.99	>.99	>.99	>.99
TERTonly vs DP	–	.10	.04^{^a}	.08	.03^{^a}	.01^{^a}	.01^{^a}
HMeD
DN vs IDHonly	–	.02^{^a}	.61	.26	.99	.86	.79
DN vs TERTonly	–	.89	.04^{^a}	.04^{^a}	.06	.21	.30
DN vs DP	–	.25	.91	.75	>.99	.96	.89
IDHonly vs TERTonly	–	.07	.44	.87	.07	<.001^{^b}	<001^{^b}
IDHonly vs DP	–	.87	>.99	.96	>.99	>.99	>.99
TERTonly vs DP	–	.75	.22	.41	.08	.002^{^b}	.002^{^b}

Note:—En dash indicates that multiple comparisons were not performed due to lack of statistical significance in the Kruskal-Wallis test.
↵a P < .05.
↵b P < .008.

Table 3:

Comparison of WB–NAWM means and HMeD of diffusion parameters for IDH and TERT mutation status

	ADC	λ₁ (AD)	RD	λ₂	λ₃	FA	RA
IDHmut Mann-Whitney test P values
WB–NAWM	.02^{^a}	.003^{^a}	.001^{^a}	.001^{^a}	.001^{^a}	<.001^{^a}	.03^{^a}
HMeD	.48	.002^{^a}	.32	.73	.055	<.001^{^a}	<.001^{^a}
TERTmut Mann-Whitney test P values
WB–NAWM	.21	.22	.09	.057	.12	.07	.07
HMeD	.73	.31	.14	.27	.054	.01^{^a}	.02^{^a}