ArticleClinical cancer research : an official journal of the American Association for Cancer Research2024
T2-FLAIR Mismatch Sign Predicts DNA Methylation Subclass and CDKN2A/B Status in IDH-Mutant Astrocytomas.
Article in Clinical cancer research : an official journal of the American Association for Cancer Research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- 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
- Effective atomic number and electron density from dual-energy CT for differentiating malignant gliomas: Validation using the World Health Organization 2021 brain tumor classification.The neuroradiology journal · 2026Observational
- T2-FLAIR mismatch sign in nonenhancing astrocytoma, IDH-mutant: impact of tumor area on diagnostic sensitivity.Journal of neuro-oncology · 2026Article
- Immune infiltration differences underlying prognostic radiomics subtypes from matched MRI and RNA sequencing in patients with lower-grade gliomas.Discover oncology · 2026Article
- MRI-based prediction of DNA methylation grade in IDH-mutant astrocytomas using qualitative imaging features and tumor volumetrics.Neuroradiology · 2025Article
- 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
- Customized SAM-Med3D with multi-view adapter and T2-FLAIR mismatch features for glioma IDH genotyping and grading.Frontiers in behavioral neuroscience · 2025Article
- Genetic and epigenetic instability as an underlying driver of progression and aggressive behavior in IDH-mutant astrocytoma.Acta neuropathologica · 2024Review
- Contrast enhancement, G-CIMP subtype, andNeuro-oncology advancesArticle
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13 authors.
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Abstract
purposeDNA methylation profiling stratifies isocitrate dehydrogenase (IDH)-mutant astrocytomas into methylation low- and high-grade groups. We investigated the utility of the T2-fluid-attenuated inversion recovery (T2-FLAIR) mismatch sign for predicting DNA methylation grade and cyclin-dependent kinase inhibitor 2A/B (CDKN2A/B) homozygous deletion, a molecular biomarker for grade 4 IDH-mutant astrocytomas, according to the 2021 World Health Organization classification. EXPERIMENTAL
designPreoperative MRI scans of IDH-mutant astrocytomas subclassified by DNA methylation profiling (n = 71) were independently evaluated by two radiologists for the T2-FLAIR mismatch sign. The diagnostic utility of T2-FLAIR mismatch in predicting methylation grade, CDKN2A/B status, copy number variation, and survival was analyzed.
resultsThe T2-FLAIR mismatch sign was present in 21 of 45 (46.7%) methylation low-grade and 1 of 26 (3.9%) methylation high-grade cases (P < 0.001), resulting in 96.2% specificity, 95.5% positive predictive value, and 51.0% negative predictive value for predicting low methylation grade. The T2-FLAIR mismatch sign was also significantly associated with intact CDKN2A/B status (P = 0.028) with 87.5% specificity, 86.4% positive predictive value, and 42.9% negative predictive value. Overall multivariable Cox analysis showed that retained CDKN2A/B status remained significant for progression-free survival (P = 0.01). Multivariable Cox analysis of the histologic grade 3 subset, which was nearly evenly divided by CDKN2A/B status, copy number variation, and methylation grade, showed trends toward significance for DNA methylation grade with overall survival (P = 0.045) and CDKN2A/B status with progression-free survival (P = 0.052).
conclusionsThe T2-FLAIR mismatch sign is highly specific for low methylation grade and intact CDKN2A/B in IDH-mutant astrocytomas.
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