ArticleJournal of neuro-oncology2026
T2-FLAIR mismatch sign in nonenhancing astrocytoma, IDH-mutant: impact of tumor area on diagnostic sensitivity.
Article in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe T2-fluid-attenuated inversion recovery (T2-FLAIR) mismatch sign is a highly specific imaging biomarker of astrocytoma, IDH-mutant; however, its clinical utility is limited by its low sensitivity. This study aimed to investigate factors contributing to false-negative findings, focusing on the impact of tumor area and quantitative thresholds used for diagnosis.
methodsThis retrospective, single-institution study included 38 patients with pathologically confirmed, nonenhancing astrocytoma. The T2-FLAIR mismatch sign was evaluated using two quantitative area cutoffs (> 50% and > 33%). Associations with CNS WHO grade, CDKN2A homozygous deletion (HD) status (assessed by MTAP surrogate), and tumor area were analyzed. Subgroup analysis was performed for 33 patients excluding cases with CDKN2A HD.
resultsThe positivity rate of the mismatch sign in nonenhancing astrocytoma increased from 55.3% at the > 50% cutoff to 73.7% at the > 33% cutoff. In the overall cohort, tumor area was significantly smaller in the mismatch-negative group compared to the mismatch-positive group; however, this difference was significant only at the > 33% threshold (p = 0.0432, Mann–Whitney U test). The group difference in tumor area became more significant at the > 33% threshold after excluding CDKN2A HD cases (p = 0.0078, Mann–Whitney U test). We observed mismatch-negative nonenhancing astrocytomas without CDKN2A HD became mismatch-positive during the tumor growth.
conclusionAbsence of the T2-FLAIR mismatch sign is an ambiguous finding representing two distinct entities: biologically aggressive tumors with CDKN2A HD or early-stage, small astrocytoma. A negative mismatch sign should not exclude astrocytoma, IDH-mutant from the differential diagnosis—particularly in small nonenhancing glioma cases.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.