Evidence map›Paper›PMID 32642675›Full record

ArticleNeuro-oncology advances

T2/FLAIR-mismatch sign for noninvasive detection of IDH-mutant 1p/19q non-codeleted gliomas: validity and pathophysiology.

Martha Foltyn, Karen Natalia Nieto Taborda, Ulf Neuberger, Gianluca Brugnara, Annekathrin Reinhardt, Damian Stichel, Sabine Heiland, Christel Herold-Mende, Andreas Unterberg, Jürgen Debus and 4 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neuro-oncology advances. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed
4.1field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 44 citations in OpenAlex.

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  11. T2-FLAIR mismatch sign correlates withJournal of neuro-oncology · 2023
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  18. T2-FLAIR mismatch sign: a roadmap of pearls and pitfalls.The British journal of radiology · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 2 institutions in 1 country.

Martha FoltynDepartment of Neuroradiology, University of Heidelberg Medical Center, Heidelberg, Germany.
Karen Natalia Nieto TabordaDepartment of Neuroradiology, University of Heidelberg Medical Center, Heidelberg, Germany.
Ulf NeubergerDepartment of Neuroradiology, University of Heidelberg Medical Center, Heidelberg, Germany.
Gianluca BrugnaraDepartment of Neuroradiology, University of Heidelberg Medical Center, Heidelberg, Germany.
Annekathrin ReinhardtDepartment of Neuropathology, University of Heidelberg Medical Center, Heidelberg, Germany.
Damian StichelDepartment of Neuropathology, University of Heidelberg Medical Center, Heidelberg, Germany.
Sabine HeilandDepartment of Neuroradiology, University of Heidelberg Medical Center, Heidelberg, Germany.
Christel Herold-MendeDepartment of Neurosurgery, University of Heidelberg Medical Center, Heidelberg, Germany.
Andreas UnterbergDepartment of Neurosurgery, University of Heidelberg Medical Center, Heidelberg, Germany.
Jürgen DebusDepartment of Radiation Oncology, University of Heidelberg Medical Center, Heidelberg Institute of Radiation Oncology and National Center for Radiation Research in Oncology, Heidelberg, Germany.
Andreas von DeimlingDepartment of Neuropathology, University of Heidelberg Medical Center, Heidelberg, Germany.
Wolfgang WickNeurology Clinic, University of Heidelberg Medical Center, Heidelberg, Germany.
Martin BendszusDepartment of Neuroradiology, University of Heidelberg Medical Center, Heidelberg, Germany.
Philipp KickingerederDepartment of Neuroradiology, University of Heidelberg Medical Center, Heidelberg, Germany.
Heidelberg University · DEGerman Cancer Research Center · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aimed to assess the validity and pathophysiology of the T2/FLAIR-mismatch sign for noninvasive identification of isocitrate dehydrogenase (IDH)-mutant 1p/19q non-codeleted glioma.

methodsMagnetic resonance imaging scans from 408 consecutive patients with newly diagnosed glioma (113 lower-grade gliomas and 295 glioblastomas) were evaluated for the presence of T2/FLAIR-mismatch sign by 2 independent reviewers. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess the performance of the T2/FLAIR-mismatch sign for identifying IDH-mutant 1p/19q non-codeleted tumors. An exploratory analysis of differences in contrast-enhancing tumor volumes, apparent diffusion coefficient (ADC) values, and relative cerebral blood volume (rCBV) values in IDH-mutant gliomas with versus without the presence of a T2/FLAIR-mismatch sign (as well as analysis of spatial differences within tumors with the presence of a T2/FLAIR-mismatch sign) was performed.

resultsThe T2/FLAIR-mismatch sign was present in 12 cases with lower-grade glioma (10.6%), all of them being IDH-mutant 1p/19q non-codeleted tumors (sensitivity = 10.9%, specificity = 100%, PPV = 100%, NPV = 3.0%, accuracy = 13.3%). There was a substantial interrater agreement to identify the T2/FLAIR-mismatch sign (Cohen's kappa = 0.75 [95% CI, 0.57-0.93]). The T2/FLAIR-mismatch sign was not identified in any other molecular subgroup, including IDH-mutant glioblastoma cases (

conclusionsThis study confirms the high specificity of the T2/FLAIR-mismatch sign for noninvasive identification of IDH-mutant 1p/19q non-codeleted gliomas; however, sensitivity is low and applicability is limited to lower-grade gliomas. Whether the higher ADC and lower rCBV values in IDH-mutant gliomas with a T2/FLAIR-mismatch sign (as compared to those without) translate into a measurable prognostic effect requires investigation in future studies. Moreover, spatial differences in ADC values between the core and rim of tumors with a T2/FLAIR-mismatch sign potentially reflect specific distinctions in tumor cellularity and microenvironment.

Indexed as

biomarkersgliomaisocitrate dehydrogenasemagnetic resonance imaging

Identifiers

PMID32642675
PMCPMC7212872
OpenAlexW2999549459

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.