Evidence map›Paper›PMID 39071736›Full record

ArticleNeuro-oncology advances

Beyond T2-FLAIR mismatch sign in isocitrate dehydrogenase mutant 1p19q non-codeleted astrocytoma: Analysis of tumor core and evolution with multiparametric magnetic resonance imaging.

Jian Ping Jen, Xuanxuan Li, Markand Patel, Huzaifah Haq, Ute Pohl, Santhosh Nagaraju, Victoria Wykes, Paul Sanghera, Colin Watts, Vijay Sawlani

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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 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

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10 authors.

Jian Ping JenDepartment of Neuroradiology, University Hospitals Birmingham, Birmingham, UK.
Xuanxuan LiDepartment of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
Markand PatelDepartment of Neuroradiology, University Hospitals Birmingham, Birmingham, UK.
Huzaifah HaqDepartment of Neuroradiology, University Hospitals Birmingham, Birmingham, UK.
Ute PohlDepartment of Cellular Pathology, University Hospitals Birmingham, Birmingham, UK.
Santhosh NagarajuDepartment of Cellular Pathology, University Hospitals Birmingham, Birmingham, UK.
Victoria WykesNeuroimaging, University of Birmingham, Birmingham, UK.
Paul SangheraNeuroimaging, University of Birmingham, Birmingham, UK.
Colin WattsNeuroimaging, University of Birmingham, Birmingham, UK.
Vijay SawlaniDepartment of Neuroradiology, University Hospitals Birmingham, Birmingham, UK.ORCID https://orcid.org/0000-0001-6779-1255

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The T2-FLAIR mismatch sign is an imaging correlate for isocitrate dehydrogenase (IDH)-mutant 1p19q non-codeleted astrocytomas. However, it is only seen in a part of the cases at certain stages. Many of the tumors likely lose T2 homogeneity as they grow in size, and become heterogenous. The aim of this study was to investigate the timecourse of T2-FLAIR mismatch sign, and assess intratumoral heterogeneity using multiparametric magnetic resonance imaging techniques. Methods: A total of 128 IDH-mutant gliomas were retrospectively analyzed. Observers blinded to molecular status used strict criteria to select T2-FLAIR mismatch astrocytomas. Pre-biopsy and follow-up standard structural sequences of T2, FLAIR and apparent diffusion coefficient, MR spectroscopy (both single- and multi-voxel techniques), and DSC perfusion were observed. Results: Nine T2-FLAIR mismatch astrocytomas were identified. 7 had MR spectroscopy and perfusion data. The smallest astrocytomas began as rounded T2 homogeneous lesions without FLAIR suppression, and developed T2-FLAIR mismatch during follow-up with falls in NAA and raised Cho/Cr ratio. Larger tumors at baseline with T2-FLAIR mismatch signs developed intratumoral heterogeneity, and showed elevated Cho/Cr ratio and raised relative cerebral blood volume (rCBV). The highest levels of intratumoral Cho/Cr and rCBV changes were located within the tumor core, and this area signifies the progression of the tumors toward high grade. Conclusions: T2-FLAIR mismatch sign is seen at a specific stage in the development of astrocytoma. By assessing the subsequent heterogeneity, MR spectroscopy and perfusion imaging are able to predict the progression of the tumor towards high grade, thereby can assist targeting for biopsy and selective debulking.

Indexed as

1p19q non-codeleted astrocytomaIDH mutantintratumoral heterogeneityspectroscopyT2-FLAIR mismatch

Identifiers

PMID39071736
PMCPMC11275453

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