DIFFUSION KURTOSIS IMAGING IDENTIFIES THE IDH MUTATION STATUS OF GLIOMAS. (3rd October 2018)

• Record Type: Journal Article
• Authors: Abdalla, Gehad; Mancini, Laura; Sanverdi, S Eser; Yousry, Tarek; Bisdas, Sotirios
• Is Part Of: Neuro-oncology. Volume 20(2018)Supplement 5
• Page Start: v351
• Page End: v351
• Publication Date: 2018-10-03
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noy129.031
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: BACKGROUND: Since the 2016 WHO classification, the mutation status of the encoding gene of Isocitrate-dehydrogenase enzyme (IDH) is an important element in the integrated diagnosis of gliomas. Diffusion Kurtosis imaging (DKI) has been used to assess the microstructure of brain tissue as well as gliomas by quantifying the water molecules' non-Gaussian distribution. We therefore hypothesize that DKI can determine the IDH status of gliomas. MATERIALS / METHODS: 20 patients (F/ M: 12/8, mean age: 39 ± 14.6 years) with histopathologically proven gliomas were included in this prospective study. Diffusion images were obtained on a 3T system with 10/ 30/ 60 diffusion gradient directions with b-value of 300–2500 sec/mm 2 . Kurtosis analysis was performed using the Diffusional Kurtosis Estimator software, and segmentation was manually drawn on the co-registered FLAIR-DWI images. The mean value of the "mean kurtosis (MK)" and "mean diffusivity (MD)" were extracted from the solid tumour component and from the contralateral normal-appearing white matter. We then correlated MK and MD with the 2016 CNS WHO tumor grades using statistical software STATA, V15. RESULTS: 7 patients had IDH-wild type (wt) gliomas and 13 IDH-mutant gliomas. Normalized MK (MKn) significantly differed between IDH-mutant and IDH-wt gliomas (p=0.04), while MDn didn't reach the statistical significance level (p=0.059). In those patients with a lack of 1p/19q co-deletion all MKn, MK, MDn, MD significantly differed (p< 0.007). CONCLUSION: DKI enables the differentiation of gliomas according to the WHO 2016 integrated diagnosis. Further studies with a larger patients' number are required to confirm these findings.