ArticleNeuroradiology2023
Association of partial T2-FLAIR mismatch sign and isocitrate dehydrogenase mutation in WHO grade 4 gliomas: results from the ReSPOND consortium.
Article in Neuroradiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 21 citations in OpenAlex.
- An Expanded T2-FLAIR Mismatch Phenotype in IDH-Mutant Astrocytomas.Journal of magnetic resonance imaging : JMRI · 2026Article
- Editorial for "An Expanded T2-FLAIR Mismatch Phenotype in IDH-Mutant Astrocytomas".Journal of magnetic resonance imaging : JMRI · 2026Article
- Imaging diagnosis of adult-type diffuse gliomas in the era of WHO CNS5 and cIMPACT-NOW updates 8-11: a narrative review.Japanese journal of radiology · 2026Review
- Conventional MRI/CT for differentiation of IDH-mutant adult-type diffuse gliomas: revisited with a new imaging feature "scFLAIR-D".Japanese journal of radiology · 2026Article
- Differentiation of Molecular Glioblastomas and Lower-grade Diffuse Astrocytomas Using MRI Perfusion and Diffusion Parameters.Clinical neuroradiology · 2026Article
- IDH mutation prediction in non-enhancing gliomas with relaxed T2-FLAIR mismatch and fractal dimension: a two-center study.BMC medical imaging · 2026Article
- Adoption of the T2-FLAIR Mismatch Sign among Radiologists: How Well Are We Doing?AJNR. American journal of neuroradiology · 2025Article
- RANO 2.0: critical updates and practical considerations for radiological assessment in neuro-oncology.Japanese journal of radiology · 2025Review
- Deep learning-based quantification of T2-FLAIR mismatch sign: extending IDH mutation prediction in adult-type diffuse lower-grade glioma.European radiology · 2025Article
- A Radiologist's Guide to IDH-Wildtype Glioblastoma for Efficient Communication With Clinicians: Part I-Essential Information on Preoperative and Immediate Postoperative Imaging.Korean journal of radiology · 2025Review
- Role of the tumor board when prescribing mutant isocitrate dehydrogenase inhibitors to patients with isocitrate dehydrogenase-mutant glioma.Neuro-oncology practice · 2025Review
- Usefulness of synthetic MRI for differentiation of IDH-mutant diffuse gliomas and its comparison with the T2-FLAIR mismatch sign.Journal of neuro-oncology · 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
- DSC-PWI presurgical differentiation of grade 4 astrocytoma and glioblastoma in young adults: rCBV percentile analysis across enhancing and non-enhancing regions.Neuroradiology · 2024Article
- MicroCT and Histological Analysis of Clot Composition in Acute Ischemic Stroke : A Comparative Study of MT-Retrieved Clots and Clot Analogs.Clinical neuroradiology · 2024Article
- Clinical and imaging characteristics of supratentorial glioma with IDH2 mutation.Neuroradiology · 2024Article
- Patterns of T2-FLAIR discordance across a cohort of adult-type diffuse gliomas and deviations from the classic T2-FLAIR mismatch sign.Neuroradiology · 2024Article
- Quantification of T2-FLAIR Mismatch in Nonenhancing Diffuse Gliomas Using Digital Subtraction.AJNR. American journal of neuroradiology · 2024Article
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Authors and funding
31 authors at 18 institutions in 4 countries.
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Abstract
purposeWhile the T2-FLAIR mismatch sign is highly specific for isocitrate dehydrogenase (IDH)-mutant, 1p/19q-noncodeleted astrocytomas among lower-grade gliomas, its utility in WHO grade 4 gliomas is not well-studied. We derived the partial T2-FLAIR mismatch sign as an imaging biomarker for IDH mutation in WHO grade 4 gliomas.
methodsPreoperative MRI scans of adult WHO grade 4 glioma patients (n = 2165) from the multi-institutional ReSPOND (Radiomics Signatures for PrecisiON Diagnostics) consortium were analyzed. Diagnostic performance of the partial T2-FLAIR mismatch sign was evaluated. Subset analyses were performed to assess associations of imaging markers with overall survival (OS).
resultsOne hundred twenty-one (5.6%) of 2165 grade 4 gliomas were IDH-mutant. Partial T2-FLAIR mismatch was present in 40 (1.8%) cases, 32 of which were IDH-mutant, yielding 26.4% sensitivity, 99.6% specificity, 80.0% positive predictive value, and 95.8% negative predictive value. Multivariate logistic regression demonstrated IDH mutation was significantly associated with partial T2-FLAIR mismatch (odds ratio [OR] 5.715, 95% CI [1.896, 17.221], p = 0.002), younger age (OR 0.911 [0.895, 0.927], p < 0.001), tumor centered in frontal lobe (OR 3.842, [2.361, 6.251], p < 0.001), absence of multicentricity (OR 0.173, [0.049, 0.612], p = 0.007), and presence of cystic (OR 6.596, [3.023, 14.391], p < 0.001) or non-enhancing solid components (OR 6.069, [3.371, 10.928], p < 0.001). Multivariate Cox analysis demonstrated cystic components (p = 0.024) and non-enhancing solid components (p = 0.003) were associated with longer OS, while older age (p < 0.001), frontal lobe center (p = 0.008), multifocality (p < 0.001), and multicentricity (p < 0.001) were associated with shorter OS.
conclusionPartial T2-FLAIR mismatch sign is highly specific for IDH mutation in WHO grade 4 gliomas.
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