MRI features predict survival and molecular markers in diffuse lower-grade gliomas.
Previous studies have shown that MR imaging features can be used to predict survival and molecular profile of glioblastoma. However, no study of a similar type has been performed on lower-grade gliomas (LGGs).



Presurgical MRIs of 165 patients with diffuse low- and intermediate-grade gliomas (histological grades II and III) were scored according to the Visually Accessible Rembrandt Images (VASARI) annotations. Radiomic models using automated texture analysis and VASARI features were built to predict isocitrate dehydrogenase 1 (IDH1) mutation, 1p/19q codeletion status, histological grade, and tumor progression.



Interrater analysis showed significant agreement in all imaging features scored (k = 0.703-1.000). On multivariate Cox regression analysis, no enhancement and a smooth non-enhancing margin were associated with longer progression-free survival (PFS), while a smooth non-enhancing margin was associated with longer overall survival (OS) after taking into account age, grade, tumor location, histology, extent of resection, and IDH1 1p/19q subtype. Using logistic regression and bootstrap testing evaluations, texture models were found to possess higher prediction potential for IDH1 mutation, 1p/19q codeletion status, histological grade, and progression of LGGs than VASARI features, with areas under the receiver-operating characteristic curves of 0.86 ± 0.01, 0.96 ± 0.01, 0.86 ± 0.01, and 0.80 ± 0.01, respectively.



No enhancement and a smooth non-enhancing margin on MRI were predictive of longer PFS, while a smooth non-enhancing margin was a significant predictor of longer OS in LGGs. Textural analyses of MR imaging data predicted IDH1 mutation, 1p/19q codeletion, histological grade, and tumor progression with high accuracy.
Department of Neurology, First Xiangya Hospital, Central South University, Changsha, Hunan, China|Department of Neurology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
Hao
H
Zhou
Medical Physics Unit, McGill University, Montréal, Québec, Canada
Martin
M
Vallières
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
Harrison X
HX
Bai
Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania
Chang
C
Su
Department of Radiology, First Xiangya Hospital, Central South University, Changsha, Hunan, China
Haiyun
H
Tang
Medical Scientist Training Program, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
Derek
D
Oldridge
Department of Radiology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
Zishu
Z
Zhang
Department of Neurology, First Xiangya Hospital, Central South University, Changsha, Hunan, China
Bo
B
Xiao
Department of Radiology, First Xiangya Hospital, Central South University, Changsha, Hunan, China
Weihua
W
Liao
Cancer Research Institute of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
Yongguang
Y
Tao
Department of Pathology, First Xiangya Hospital, Central South University, Changsha, Hunan, China
Jianhua
J
Zhou
Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
Paul
P
Zhang
Department of Neurology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
Li
L
Yang
D014408:Biomarkers, Tumor / Q000235:genetics*; D001932:Brain Neoplasms / Q000235:genetics / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002872:Chromosome Deletion; D002878:Chromosomes, Human, Pair 1; D002888:Chromosomes, Human, Pair 19; D003131:Combined Modality Therapy; D018450:Disease Progression; D005500:Follow-Up Studies; D005910:Glioma / Q000235:genetics / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D007521:Isocitrate Dehydrogenase / Q000235:genetics*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009154:Mutation; D060787:Neoplasm Grading; D015996:Survival Rate
D014408:Biomarkers, Tumor; D007521:Isocitrate Dehydrogenase
1p/19q codeletion; IDH1 mutation; MR imaging; lower-grade gliomas; texture analysis