ArticleEuropean radiology2022
Combining hyperintense FLAIR rim and radiological features in identifying IDH mutant 1p/19q non-codeleted lower-grade glioma.
Article in European radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 20 citations in OpenAlex.
- Prognostic Impact of Calcification, Corpus Callosum Invasion, and CDKN2A/B Hemizygous Deletion in Oligodendroglioma: A Single-center Retrospective Study.Neurologia medico-chirurgica · 2026Article
- Review
- Deep learning-based quantification of T2-FLAIR mismatch sign: extending IDH mutation prediction in adult-type diffuse lower-grade glioma.European radiology · 2025Article
- Magnetic resonance spectroscopy for enhanced multiparametric MRI characterization of [EJNMMI research · 2025Article
- Tumour surface regularity predicts survival and benefit from gross total resection in IDH-wildtype glioblastoma patients.Insights into imaging · 2025Article
- Comprehensive multicentre retrospective analysis for predicting isocitrate dehydrogenase-mutant lower-grade gliomas.Annals of clinical and translational neurology · 2025Article
- Magnetic resonance imaging-based deep learning for predicting subtypes of glioma.Frontiers in neurology · 2025Article
- Diffusion MRI is superior to quantitative T2-FLAIR mismatch in predicting molecular subtypes of human non-enhancing gliomas.Neuroradiology · 2024Article
- Unveiling hierarchy and spatial distribution of OCancer science · 2024Article
- The T2-FLAIR mismatch sign in oncologic neuroradiology: History, current use, emerging data, and future directions.The neuroradiology journal · 2024Review
- Intratumoral calcification: not only a diagnostic but also a prognostic indicator in oligodendrogliomas.European radiology · 2024Article
- Clinical and imaging characteristics of supratentorial glioma with IDH2 mutation.Neuroradiology · 2024Article
- Quantification of T2-FLAIR Mismatch in Nonenhancing Diffuse Gliomas Using Digital Subtraction.AJNR. American journal of neuroradiology · 2024Article
- Nonhematogenic circulating aneuploid cells confer inferior prognosis and therapeutic resistance in gliomas.Cancer science · 2022Article
- Relative T2-FLAIR signal intensity surrounding residual cavity is associated with survival prognosis in patients with lower-grade gliomas.Frontiers in oncology · 2022Article
- Establishment and validation of a nomogram for predicting IDH-wildtype glioblastomas in nonenhancing adult-type diffuse gliomas.Neuro-oncology advancesArticle
- Identifying IDH-mutant and 1p/19q noncodeleted astrocytomas from nonenhancing gliomas: Manual recognition followed by artificial intelligence recognition.Neuro-oncology advancesArticle
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11 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesEven very small residual tumors of IDH mutant 1p/19q non-codeleted (IDHmut-Noncodel) astrocytoma could have a significantly negative impact on survival; thus, accurate preoperative diagnosis is of utmost importance to guide aggressive tumor resection strategy for this subtype. This study aimed to diagnose IDHmut-Noncodel from IDH mutant 1p/19q codeleted (IDHmut-Codel) and IDH wild-type gliomas by preoperative MRI and CT to guide surgical plan-making.
methodsConsecutive adult patients diagnosed with diffuse lower-grade glioma (LGG, histological grade 2-3) from December 1, 2013 to December 31, 2020, were retrospectively included in this study. Clinical and radiological features were recorded and analyzed. Patients were divided into cohort A and cohort B for training and validation based on the operation date (2:1).
resultsA total of 585 patients were included in this study (cohort A, 390; cohort B, 195). The hyperintense FLAIR rim with hypointense core (hyperFLAIRrim) was a more sensitive sign than T2-FLAIR mismatch (T2FM) in defining IDHmut-Noncodel astrocytoma (sensitivity in cohort A: 0.713, 0.539, respectively; in cohort B: 0.713, 0.489, respectively) without compromised specificity (all 1.00). The hyperFLAIRrim, higher rADC, homogenous pattern on T2WI, non-calcification, and younger age were the most important factors associated with IDHmut-Noncodel astrocytoma. Combining these factors, the random forest model showed the best predictive ability.
conclusionThe hyperFLAIRrim sign was a specific and more sensitive sign in diagnosing IDHmut-Noncodel astrocytoma. Combining hyperFLAIRrim, higher rADC, homogenous pattern, non-calcification, and younger age could precisely predict glioma subtype for subsequent surgical plan-making. KEY POINTS: • A single hyperintense FLAIR rim (hyperFLAIRrim) sign with a hypointense core, regardless of T2 appearance, was more sensitive than T2FM in diagnosing IDHmut-Noncodel astrocytoma with high specificity. • The higher rADC value, homogenous pattern on T2WI, non-calcification, and younger age have a close relationship with IDHmut-Noncodel astrocytoma. • Neurosurgeons should perform a more aggressive resection strategy to prolong survival for radiologically indicated IDHmut-Noncodel astrocytoma. Our study provided a usable, practicable, and reliable protocol for neurosurgeons to make an individualized surgical strategy.
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