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Predictive value of T2-weighted perfusion and T1-weighted permeability MRI parameters in determining IDH mutational status and grade of gliomas

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KUH (KOÇ UNIVERSITY HOSPITAL)

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Karagulle, Mehmet
Ozdemir, Merve Sam
Mutlu, Samet
Kocak, Burak

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AIM: To assess the performance metrics of perfusion and permeability magnetic resonance imaging (MRI) parameters with optimal cut-offs in differentiating isocitrate dehydrogenase (IDH) genotype and tumor grade in patients with grade 2-4 gliomas. MATERIAL and METHODS: This retrospective study included 36 patients surgically diagnosed with grade 2-4 glioma (six grade 2, seven grade 3, and 23 grade 4) with known IDH genotypes (23 IDH wild-type, 13 IDH mutant) between November 2021 and August 2023. All patients underwent preoperative perfusion and permeability MRI examinations with a 3.0 Tesla scanner. Parameters were calculated on colored map images. Using the intraclass correlation coefficient, intra- and inter-observer agreement was assessed. Following multiple testing correction, the perfusion parameters with statistically significant differences were subjected to receiver operating characteristic (ROC) analysis. RESULTS: Five MRI parameters (rCBV and rCBF from perfusion;Ktrans, Ve, and Vp from permeability) showed a significant difference between groups in terms of IDH genotype (p<0.001). In ROC analysis, the best parameters in differentiating IDH genotype included rCBV and Ktrans;rCBV with a cut-off of 5.58 achieved an area under the ROC curve (AUC), sensitivity, specificity, and accuracy of 0.883, 95.7%, 76.9%, and 88.8%, respectively. For Ktrans, with a cut-off of 0.0727 min-1, these values were 0.893, 100%, 69.2%, and 88.8%, respectively. In ROC analysis, these two parameters with rCBF and Ve also showed good performance in differentiating low- and high-grade gliomas with an AUC, sensitivity, and accuracy exceeding 0.940, 86%, and 88%, respectively. CONCLUSION: Perfusion and permeability MRI may provide useful parameters in differentiating the IDH genotype and grade of gliomas

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Türk Nöroşirürji Derneği

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Clinical neurology, Surgery

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Turkish Neurosurgery

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10.5137/1019-5149.JTN.46251-24.3

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