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The diagnostic efficiency of integration of 2HG MRS and IVIM versus individual parameters for predicting IDH mutation status in gliomas in clinical scenarios: A retrospective study

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Abstract

Purpose

Currently, there remains a scarcity of established preoperative tests to accurately predict the isocitrate dehydrogenase (IDH) mutation status in clinical scenarios, with limited research has explored the potential synergistic diagnostic performance among metabolite, perfusion, and diffusion parameters. To address this issue, we aimed to develop an imaging protocol that integrated 2-hydroxyglutarate (2HG) magnetic resonance spectroscopy (MRS) and intravoxel incoherent motion (IVIM) by comprehensively assessing metabolic, cellular, and angiogenic changes caused by IDH mutations, and explored the diagnostic efficiency of this imaging protocol for predicting IDH mutation status in clinical scenarios.

Methods

Patients who met the inclusion criteria were categorized into two groups: IDH-wild type (IDH-WT) group and IDH-mutant (IDH-MT) group. Subsequently, we quantified the 2HG concentration, the relative apparent diffusion coefficient (rADC), the relative true diffusion coefficient value (rD), the relative pseudo-diffusion coefficient (rD*) and the relative perfusion fraction value (rf). Intergroup differences were estimated using t-test and Mann–Whitney U test. Finally, we performed receiver operating characteristic (ROC) curve and DeLong’s test to evaluate and compare the diagnostic performance of individual parameters and their combinations.

Results

64 patients (female, 21; male, 43; age, 47.0 ± 13.7 years) were enrolled. Compared with IDH-WT gliomas, IDH-MT gliomas had higher 2HG concentration, rADC and rD (P < 0.001), and lower rD* (P = 0.013). The ROC curve demonstrated that 2HG + rD + rD* exhibited the highest areas under curve (AUC) value (0.967, 95%CI 0.889–0.996) for discriminating IDH mutation status. Compared with each individual parameter, the predictive efficiency of 2HG + rADC + rD* and 2HG + rD + rD* shows a statistically significant enhancement (DeLong’s test: P < 0.05).

Conclusions

The integration of 2HG MRS and IVIM significantly improves the diagnostic efficiency for predicting IDH mutation status in clinical scenarios.

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Data availability

The datasets analysed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by National Natural Science Foundation of China (21927808, 81702451, 81930048).

Author information

Author notes

  1. Meimei Yu and Ying Ge contributed equally.

Authors and Affiliations

  1. Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China

    Meimei Yu, Ying Ge, Xinyi Hou, Hongyan Chen, Xuzhu Chen & Huicong Shen

  2. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Yang Zhang & Nan Ji

  3. State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Zixuan Wang & Xin Li

  4. Department of Radiology, The First People’s Hospital of Longquanyi District, Chengdu, Sichuan Province, China

    Meimei Yu

  5. Department of Radiology, Beijing Huimin Hospital, Beijing, China

    Ying Ge

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Contributions

Huicong Shen contributed to the study conception and design.

All authors contributed to material preparation, data collection.

Meimei Yu and Ying Ge contributed to data analysis and interpretation.

The first draft of the manuscript was written by Meimei Yu and Ying Ge, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Huicong Shen.

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This is an observational study. The Beijing Tiantan Hospital Research Ethics Committee has confirmed that no ethical approval is required.

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Informed consent was obtained from all individual participants included in the study.

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The authors affirm that human research participants provided informed consent for publication of the images in Fig. 1.

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Yu, M., Ge, Y., Wang, Z. et al. The diagnostic efficiency of integration of 2HG MRS and IVIM versus individual parameters for predicting IDH mutation status in gliomas in clinical scenarios: A retrospective study. J Neurooncol 167, 305–313 (2024). https://doi.org/10.1007/s11060-024-04609-2

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