Prediction of isocitrate dehydrogenase genotype in brain gliomas with MRI: single-shell versus multishell diffusion models
Open accessAbstract
Purpose The primary aim of this prospective observational study was to assess whether diffusion MRI metrics correlate with isocitrate dehydrogenase (IDH) status in grade II and III gliomas. A secondary aim was to investigate whether multishell acquisitions with advanced models such as neurite orientation dispersion and density imaging (NODDI) and diffusion kurtosis imaging offer greater diagnostic accuracy than diffusion-tensor imaging (DTI). Materials and Methods Diffusion MRI (b = 700 and 2000 sec/mm2) was performed preoperatively in 192 consecutive participants (113 male and 79 female participants; mean age, 46.18 years; age range, 14–77 years) with grade II (n = 62), grade III (n = 58), or grade IV (n = 72) gliomas. DTI, diffusion kurtosis imaging, and NODDI metrics were measured in regions with or without hyperintensity on diffusion MR images and compared among groups defined according to IDH genotype, 1p/19q codeletion status, and tumor grade by using Mann-Whitney tests. Results In grade II and III IDH wild-type gliomas, the maximum fractional anisotropy, kurtosis anisotropy, and restriction fraction were significantly higher and the minimum mean diffusivity was significantly lower than in IDH-mutant gliomas (P = .011, P = .002, P = .044, and P = .027, respectively); areas under the receiver operating characteristic curve ranged from 0.72 to 0.76. In IDH wild-type gliomas, no difference among grades II, III, and IV was found. In IDH-mutant gliomas, no difference between those with and those without 1p/19q loss was found. Conclusion Diffusion MRI metrics showed correlation with isocitrate dehydrogenase status in grade II and III gliomas. Advanced diffusion MRI models did not add diagnostic accuracy, supporting the inclusion of a single-shell diffusion-tensor imaging acquisition in brain tumor imaging protocols. Published under a CC BY 4.0 license. Online supplemental material is available for this article.
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The performance of NODDI for tumor grading is comparable with that of mean kurtosis.
“The performance of NODDI for tumor grading is comparable with that of mean kurtosis (Figini et al., 2018;Maximov et al., 2017)”
From NODDI in clinical research (2020) · cites this paper as Figini et al., 2018
The section “Correlation of Diffusion MRI Metrics with Glioma Grade, Histotype, and Cell Proliferation Index” (p. 5) reports that both NODDI and diffusion-kurtosis metrics distinguished grade IV from grade II and III gliomas, while neither distinguished grade II from grade III. This supports a broad similarity, but the paper does not directly compare NODDI’s tumor-grading performance with that of mean kurtosis specifically. (LLM, conf=0.82)
Experimental — accuracy not yet measuredNeither NODDI nor DKI has shown a particular benefit over DTI in predicting isocitrate dehydrogenase-1 gene mutation status.
“although neither NODDI nor DKI have shown a particular benefit over DTI in predicting isocitrate dehydrogenase-1 gene mutation status (Figini et al., 2018;Zhao et al., 2018).”
From NODDI in clinical research (2020) · cites this paper as Figini et al., 2018
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- Authors
- Figini, M., Riva, M., Graham, M., Castelli, G. M., Fernandes, B., Grimaldi, M., Baselli, G., Pessina, F., Bello, L., Zhang, H., & Bizzi, A.
- Affiliations
- University of Milan (IT)
- ORCID
- Venue
- Radiology
- Published
- 2018-12
- Volume
- 289
- Issue
- 3
- Pages
- 788-796
- ISSN
- 0033-8419 (ISSN-L)
- 1527-1315
- OpenAlex
- W2892516306
- Cited by
- 49
- References
- 32
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 6 · 2023: 10 · 2022: 4 · 2021: 6 · 2020: 7 · 2019: 5
- FWCI
- 3.13
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Radiology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, cc-by)
- Virtual Community of Pathological Anatomy (University of Castilla La Mancha) (submittedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Fondazione Italiana per la Ricerca sul Cancro
- Medical Research Council (MR/L011530/1)
- Engineering and Physical Sciences Research Council (N018702, EP/L016478/1, EP/R006032/1, EP/M020533/1, EP/N018702/1, EP/L504889/1, EP/N018702/)
- FP7 Information and Communication Technologies
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Health Sciences › Medicine › Genetics › Glioma Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › MRI in cancer diagnosis
- Keywords
- IDH mutation, glioma, diffusion MRI, diffusion kurtosis imaging, NODDI, diffusion tensor imaging, fractional anisotropy, 1p/19q codeletion, brain tumor imaging, diagnostic accuracy
- MeSH terms
- Adolescent, Adult, Aged, Brain, Brain Neoplasms, Female, Genotype, Glioma, Humans, Immunohistochemistry, Isocitrate Dehydrogenase, Magnetic Resonance Imaging, Male, Middle Aged, Mutation, Prospective Studies, Reproducibility of Results, Diffusion Magnetic Resonance Imaging, Young Adult, Diffusion Tensor Imaging, Neuroimaging
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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