title: Evaluation of the microenvironmental heterogeneity in high-grade gliomas with IDH1/2 gene mutation using histogram analysis of diffusion-weighted imaging and dynamic-susceptibility contrast perfusion imaging.
abstract: The purpose of our study was to explore the difference between isocitrate dehydrogenase (IDH)-1/2 gene mutation-positive and -negative high-grade gliomas (HGGs) using histogram analysis of apparent diffusion coefficient (ADC) and normalized cerebral blood volume (nCBV) maps. We enrolled 52 patients with histopathologically confirmed HGGs with IDH1/2 (P) (n = 16) or IDH1/2 (N) (n = 36). Histogram parameters of ADC and nCBV maps were correlated with gene mutations by using the unpaired student's t test and multivariable stepwise logistic regression analysis. The mean ADC value was higher in the IDH1 (P) group than IDH1 (N) (1,282.8 vs. 1,159.6 mm(2)/s, P = .0113). In terms of the cumulative ADC histograms, the 10th and 50th percentile values were also higher in the IDH1 (P) than IDH1 (N) (P = .0104 and .0183, respectively). We observed a higher 90th percentile value (3.121 vs. 2.397, P = .0208) and a steeper slope between the 10th (C10) and 90th (C90) of cumulative nCBV histograms (0.03386 vs. 0.02425/%, P = .0067) in the IDH1 (N) group. Multivariate analysis showed that the mean ADC mean value (P = .0048), the C90 value (P = .0113), and the slope between C10 and C90 (P = .0049) were the significant variables in the differentiation of IDH1 (P) from IDH1 (N). In conclusion, histogram analysis of ADC and nCBV maps based on entire tumor volume can be a useful tool for distinguishing IDH1 (P) and IDH1 (N), and it predicts that IDH (P) tumors have a more heterogeneous microenvironment than IDH (N) ones.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, 28, Yongon-dong, Chongno-gu, Seoul, 110-744, Korea.
authors.forename: Seunghyun
authors.initials: S
authors.lastname: Lee
authors.forename: Seung Hong
authors.initials: SH
authors.lastname: Choi
authors.forename: Inseon
authors.initials: I
authors.lastname: Ryoo
authors.forename: Tae Jin
authors.initials: TJ
authors.lastname: Yoon
authors.forename: Tae Min
authors.initials: TM
authors.lastname: Kim
authors.forename: Se-Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Chul-Kee
authors.initials: CK
authors.lastname: Park
authors.forename: Ji-Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Chul-Ho
authors.initials: CH
authors.lastname: Sohn
authors.forename: Sung-Hye
authors.initials: SH
authors.lastname: Park
authors.forename: Il Han
authors.initials: IH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D001932:Brain Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology* / Q000601:surgery; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007521:Isocitrate Dehydrogenase / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D060787:Neoplasm Grading; D055420:Perfusion Imaging / Q000379:methods; D047368:Tumor Burden; D059016:Tumor Microenvironment; D055815:Young Adult
chemical_list: D015415:Biomarkers; D003287:Contrast Media; C538784:IDH2 protein, human; D007521:Isocitrate Dehydrogenase; C543588:IDH1 protein, human