In vivo molecular profiling of human glioma using diffusion kurtosis imaging.
The purpose of this study is to assess the diagnostic performance of diffusion kurtosis imaging (DKI) for in vivo molecular profiling of human glioma. Normalized mean kurtosis (MKn) and mean diffusivity (MDn) metrics from DKI were assessed in 50 patients with histopathologically confirmed glioma. The results were compared in regard to the WHO-based histological findings and molecular characteristics leading to integrated diagnosis (Haarlem Consensus): isocitrate-dehydrogenase (IDH1/2) mutation status, alpha-thalassemia/mental retardation syndrome X-linked (ATRX) expression, chromosome 1p/19q loss of heterozygosity (LOH), and O6-methylguanine DNA methyltransferase (MGMT) promoter methylation status. MKnwas significantly lower in tumors with IDH1/2 mutation (0.43 ± 0.09) and ATRX loss of expression (0.41 ± 0.11) than in those with IDH1/2 wild type (0.57 ± 0.09, p < 0.001) and ATRX maintained expression (0.51 ± 0.10, p = 0.004), respectively. Regarding the integrated molecular diagnosis, MKnwas significantly higher in primary glioblastoma (0.57 ± 0.10) than in astrocytoma (0.39 ± 0.11, p < 0.001) and oligodendroglioma (0.47 ± 0.05, p = 0.003). MK may be used to provide insight into the human glioma molecular profile regarding IDH1/2 mutation status and ATRX expression. Considering the diagnostic and prognostic significance of these molecular markers, MK appears to be a promising in vivo biomarker for glioma. The diagnostic performance of MK seems to fit more with the integrated molecular approach than the conventional histological findings of the current WHO 2007 classification.
Department of Neuroradiology, Eberhard Karls University, Tübingen, Germany. johann-martin.hempel@uni-tuebingen.de.
Johann-Martin
0000-0002-9647-5136
JM
Hempel
Department of Neuroradiology, Eberhard Karls University, Tübingen, Germany.|Department of Neuroradiology, National Hospital of Neurology and Neurosurgery, University College London Hospitals, London, UK.
Sotirios
S
Bisdas
Institute of Neuropathology, Eberhard Karls University, Tübingen, Germany.
Jens
J
Schittenhelm
Department of Neuroradiology, Eberhard Karls University, Tübingen, Germany.
Cornelia
C
Brendle
Department of Neuroradiology, Eberhard Karls University, Tübingen, Germany.
Benjamin
B
Bender
Department of Neuroradiology, Eberhard Karls University, Tübingen, Germany.
Henk
H
Wassmann
Department of Neurosurgery, Eberhard Karls University, Tübingen, Germany.
Marco
M
Skardelly
Centre of Neurooncology, Comprehensive Cancer Center Tübingen-Stuttgart, Eberhard Karls University, Tübingen, Germany.
Ghazaleh
G
Tabatabai
Department of Preclinical Imaging and Radiopharmacy, Werner Siemens Imaging Center, Eberhard Karls University, Tübingen, Germany.
Salvador Castaneda
SC
Vega
Department of Neuroradiology, Eberhard Karls University, Tübingen, Germany.
Ulrike
U
Ernemann
Department of Neuroradiology, Eberhard Karls University, Tübingen, Germany.
Uwe
U
Klose
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000235:genetics*; D002869:Chromosome Aberrations; D002878:Chromosomes, Human, Pair 1 / Q000235:genetics; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000000981:diagnostic imaging* / Q000235:genetics*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007521:Isocitrate Dehydrogenase / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D019853:O(6)-Methylguanine-DNA Methyltransferase / Q000235:genetics; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D055815:Young Adult; D017085:alpha-Thalassemia / Q000235:genetics
D007521:Isocitrate Dehydrogenase; D019853:O(6)-Methylguanine-DNA Methyltransferase
1p/19q LOH; ATRX; Diffusion kurtosis imaging; Glioma; Haarlem consensus; IDH1/2; Integrated diagnosis; Isocitrate dehydrogenase; MGMT