ReviewThe neuroradiology journal2024
The T2-FLAIR mismatch sign in oncologic neuroradiology: History, current use, emerging data, and future directions.
Review in The neuroradiology journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- 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
- Magnetic resonance imaging findings of dysembryoplastic neuroepithelial tumors and low-grade astrocytomas.Journal of the Chinese Medical Association : JCMA · 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
- Spatial invasion patterns of temporal lobe glioblastoma after complete resection of contrast-enhancing tumor.Journal of neuro-oncology · 2025Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
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Abstract
The T2-Fluid-Attenuated Inversion Recovery (T2-FLAIR) mismatch sign is a radiogenomic marker that is easily discernible on preoperative conventional MR imaging. Application of strict criteria (adult population, cerebral hemisphere location, and classic imaging morphology) permits the noninvasive preoperative diagnosis of isocitrate dehydrogenase (IDH)-mutant 1p/19q-non-codeleted diffuse astrocytoma with near-perfect specificity, albeit with variably low sensitivity. This leads to improved preoperative planning and patient counseling. More recent research has shown that the application of less strict criteria compromises the near-perfect specificity of the sign but remains adequate for ruling out IDH-wildtype (glioblastoma) phenotype, which bears a far grimmer prognosis compared to IDH-mutant diffuse astrocytic disease. In this review, we elaborate on the various definitions of the T2-FLAIR mismatch sign present in the literature, illustrate these with images obtained at a comprehensive cancer center, discuss the potential of the mismatch sign for application to certain pediatric-type brain tumors, namely dysembryoplastic neuroepithelial tumor and diffuse midline glioma, and elaborate upon the clinical, histologic, and molecular associations of the T2-FLAIR mismatch sign as recognized to date. Finally, the sign's correlates in diffusion- and perfusion-weighted imaging are presented, and opportunities to further maximize the diagnostic and prognostic applications of the sign in the context of the 2021 revision of the WHO Classification of Central Nervous System Tumors are discussed.
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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.