51. Predicting Isocitrate Dehydrogenase Status in Non-Contrast-Enhanced Adult-Type Astrocytic Tumors Using Diffusion Tensor Imaging and 11 C-Methionine, 11 C-Choline, and 18 F-Fluorodeoxyglucose PET.
- Author
-
Yasuda, Shoji, Yano, Hirohito, Ikegame, Yuka, Ikuta, Soko, Maruyama, Takashi, Kumagai, Morio, Muragaki, Yoshihiro, Iwama, Toru, Shinoda, Jun, and Izumo, Tsuyoshi
- Subjects
BRAIN physiology ,PREOPERATIVE period ,GLIOMAS ,RADIOPHARMACEUTICALS ,PREDICTION models ,DEOXY sugars ,MAGNETIC resonance imaging ,POSITRON emission tomography ,METHIONINE ,DESCRIPTIVE statistics ,CHOLINE ,THALAMUS ,OXIDOREDUCTASES ,GENETIC mutation ,BRAIN tumors ,OVERALL survival - Abstract
Simple Summary: Predicting the isocitrate dehydrogenase (IDH) mutation status is difficult in preoperative non-enhanced astrocytic tumors. We aimed to differentiate IDH status using preoperative MRI and PET. We found that patients with IDH-mutant (mut) astrocytomas were significantly younger than those with IDH-wildtype (wt) glioblastomas. The tumor location, fractional anisotropy, and mean diffusivity on MRI were significantly related to the IDH mutation status. PET showed significantly higher uptakes for
11 C-methionine,11 C-choline, and18 F-fluorodeoxyglucose in IDH-wt than in IDH-mut tumors. Together, these findings reflect the higher malignancy of IDH-wt than of IDH-mut tumors. Composite diagnosis using age, MRI, and PET findings resulted in high accuracy for predicting IDH status. Thus, approaches based on biological tumor behavior in early-stage gliomas are helpful for guiding preoperative treatment decisions. We aimed to differentiate the isocitrate dehydrogenase (IDH) status among non-enhanced astrocytic tumors using preoperative MRI and PET. We analyzed 82 patients with non-contrast-enhanced, diffuse, supratentorial astrocytic tumors (IDH mutant [IDH-mut], 55 patients; IDH-wildtype [IDH-wt], 27 patients) who underwent MRI and PET between May 2012 and December 2022. We calculated the fractional anisotropy (FA) and mean diffusivity (MD) values using diffusion tensor imaging. We evaluated the tumor/normal brain uptake (T/N) ratios using11 C-methionine,11 C-choline, and18 F-fluorodeoxyglucose PET; extracted the parameters with significant differences in distinguishing the IDH status; and verified their diagnostic accuracy. Patients with astrocytomas were significantly younger than those with glioblastomas. The following MRI findings were significant predictors of IDH-wt instead of IDH-mut: thalamus invasion, contralateral cerebral hemisphere invasion, location adjacent to the ventricular walls, higher FA value, and lower MD value. The T/N ratio for all tracers was significantly higher for IDH-wt than for IDH-mut. In a composite diagnosis based on nine parameters, including age, 84.4% of cases with 0–4 points were of IDH-mut; conversely, 100% of cases with 6–9 points were of IDH-wt. Composite diagnosis using all parameters, including MRI and PET findings with significant differences, may help guide treatment decisions for early-stage gliomas. [ABSTRACT FROM AUTHOR]- Published
- 2024
- Full Text
- View/download PDF