ArticleBMC cancer2020
The clinical significance of the T2-FLAIR mismatch sign in grade II and III gliomas: a population-based study.
Article in BMC cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers.
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39 citing papers in PubMed, 52 citations in OpenAlex.
- An Expanded T2-FLAIR Mismatch Phenotype in IDH-Mutant Astrocytomas.Journal of magnetic resonance imaging : JMRI · 2026Article
- Review
- Isocitrate Dehydrogenase-Mutant Astrocytomas: Risk Stratification and Therapeutic Advance.MedComm · 2026Review
- Reliable cognitive changes the first year following guideline-based treatment of isocitrate dehydrogenase mutated gliomas: A longitudinal multicenter study.Neuro-oncology · 2026Article
- Clinical, molecular, and radiological predictors of prognosis in newly diagnosed astrocytoma, IDH-mutant, WHO grade 4.Neuro-oncology · 2025Article
- Adoption of the T2-FLAIR Mismatch Sign among Radiologists: How Well Are We Doing?AJNR. American journal of neuroradiology · 2025Article
- Survival prediction with radiomics for patients with IDH mutated lower-grade glioma.Journal of neuro-oncology · 2025Article
- Morphometric and radiomics analysis toward the prediction of epilepsy associated with supratentorial low-grade glioma in children.Cancer imaging : the official publication of the International Cancer Imaging Society · 2025Article
- Mental fatigue and cognitive functioning in patients presenting with non-enhancing gliomas.Acta neurochirurgica · 2025Article
- Preoperative prediction of diffuse glioma type and grade in adults: a gadolinium-free MRI-based decision tree.European radiology · 2025Article
- Role of the tumor board when prescribing mutant isocitrate dehydrogenase inhibitors to patients with isocitrate dehydrogenase-mutant glioma.Neuro-oncology practice · 2025Review
- Comprehensive multicentre retrospective analysis for predicting isocitrate dehydrogenase-mutant lower-grade gliomas.Annals of clinical and translational neurology · 2025Article
- Unravelling differences and hallmarks in suspected diffuse low-grade gliomas: a multicentre database study.Brain communications · 2025Article
- Diffusion MRI is superior to quantitative T2-FLAIR mismatch in predicting molecular subtypes of human non-enhancing gliomas.Neuroradiology · 2024Article
- T2-FLAIR Mismatch Sign Predicts DNA Methylation Subclass and CDKN2A/B Status in IDH-Mutant Astrocytomas.Clinical cancer research : an official journal of the American Association for Cancer Research · 2024Article
- The T2-FLAIR mismatch sign in oncologic neuroradiology: History, current use, emerging data, and future directions.The neuroradiology journal · 2024Review
- Quantification of T2-FLAIR Mismatch in Nonenhancing Diffuse Gliomas Using Digital Subtraction.AJNR. American journal of neuroradiology · 2024Article
- T2-FLAIR mismatch sign correlates withJournal of neuro-oncology · 2023Article
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundThe T2-FLAIR mismatch sign is an imaging finding highly suggestive of isocitrate dehydrogenase mutated (IDH-mut) 1p19q non-codeleted (non-codel) gliomas (astrocytomas). In previous studies, it has shown excellent specificity but limited sensitivity for IDH-mut astrocytomas. Whether the mismatch sign is a marker of a clinically relevant subtype of IDH-mut astrocytomas is unknown.
methodsWe included histopathologically verified supratentorial lower-grade gliomas (LGG) WHO grade II-III retrospectively during the period 2010-2016. In the period 2017-2018, patients with suspected LGG radiologically were prospectively included, and in this cohort other diagnoses than glioma could occur. Clinical, radiological and molecular data were collected. For clinical evaluation we included all patients with IDH-mut astrocytomas. In the 2010-2016 cohort DNA methylation analysis with Infinium MethylationEPIC BeadChip (Illumina) was performed for patients with an IDH-mut astrocytoma with available tissue. We aimed to examine the association of the T2-FLAIR mismatch sign with clinical factors and outcomes. Additionally, we evaluated the diagnostic reliability of the mismatch sign and its relation to methylation profiles.
resultsOut of 215 patients with LGG, 135 had known IDH-mutation and 1p19q codeletion status. Fifty patients had an IDH-mut astrocytoma and 12 of these (24.0%) showed a mismatch sign. The sensitivity and specificity of the mismatch sign for IDH-mut detection were 26.4 and 97.6%, respectively. There were no differences between patients with an IDH-mut astrocytoma with or without mismatch sign when grouped according to T2-FLAIR mismatch sign with respect to baseline characteristics, clinical outcomes and methylation profiles. The overall interrater agreement between neuroradiologist and clinical neurosurgeons for the T2-FLAIR mismatch sign was significant when all 215 MRI examination assessed (κ = 0.77, p < 0.001, N = 215).
conclusionThe T2-FLAIR mismatch sign in patients with an IDH-mut astrocytoma is not associated with clinical presentation or outcome. It seems unlikely that the IDH-mut astrocytomas with mismatch sign represent a specific subentity. Finally, we have validated that the T2-FLAIR mismatch sign is a reliable and specific marker of IDH-mut astrocytomas.
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