A Systematic Review and Meta-analysis on the Differentiation of Glioma Grade and Mutational Status by Use of Perfusion-based Magnetic Resonance Imaging

Overview

Journal Insights Imaging

Publisher Springer

Specialty Radiology

Date 2022 Jun 7

PMID 35670981

Authors

Lusien van Santwijk

Valentina Kouwenberg

Frederick Meijer

Marion Smits

Dylan Henssen

Affiliations

Soon will be listed here.

Abstract

Background: Molecular characterization plays a crucial role in glioma classification which impacts treatment strategy and patient outcome. Dynamic susceptibility contrast (DSC) and dynamic contrast enhanced (DCE) perfusion imaging have been suggested as methods to help characterize glioma in a non-invasive fashion. This study set out to review and meta-analyze the evidence on the accuracy of DSC and/or DCE perfusion MRI in predicting IDH genotype and 1p/19q integrity status.

Methods: After systematic literature search on Medline, EMBASE, Web of Science and the Cochrane Library, a qualitative meta-synthesis and quantitative meta-analysis were conducted. Meta-analysis was carried out on aggregated AUC data for different perfusion metrics.

Results: Of 680 papers, twelve were included for the qualitative meta-synthesis, totaling 1384 patients. It was observed that CBV, ktrans, Ve and Vp values were, in general, significantly higher in IDH wildtype compared to IDH mutated glioma. Meta-analysis comprising of five papers (totaling 316 patients) showed that the AUC of CBV, ktrans, Ve and Vp were 0.85 (95%-CI 0.75-0.93), 0.81 (95%-CI 0.74-0.89), 0.84 (95%-CI 0.71-0.97) and 0.76 (95%-CI 0.61-0.90), respectively. No conclusive data on the prediction of 1p/19q integrity was available from these studies.

Conclusions: Future research should aim to predict 1p/19q integrity based on perfusion MRI data. Additionally, correlations with other clinically relevant outcomes should be further investigated, including patient stratification for treatment and overall survival.

Citing Articles

Research Progress on Glioma Microenvironment and Invasiveness Utilizing Advanced Multi-Parametric Quantitative MRI.

Song D, Fan G, Chang M Cancers (Basel). 2025; 17(1.

PMID: 39796702 PMC: 11719598. DOI: 10.3390/cancers17010074.

Impact of Sex Hormones on Glioblastoma: Sex-Related Differences and Neuroradiological Insights.

Rossi J, Zedde M, Napoli M, Pascarella R, Pisanello A, Biagini G Life (Basel). 2025; 14(12.

PMID: 39768232 PMC: 11677825. DOI: 10.3390/life14121523.

Distributed parameter model of dynamic contrast-enhanced MRI in the identification of IDH mutation, 1p19q codeletion, and tumor cell proliferation in glioma patients.

Zhao K, Huang H, Gao E, Qi J, Chen T, Zhao G Front Oncol. 2024; 14:1333798.

PMID: 39525622 PMC: 11544007. DOI: 10.3389/fonc.2024.1333798.

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

Jen J, Li X, Patel M, Haq H, Pohl U, Nagaraju S Neurooncol Adv. 2024; 6(1):vdae065.

PMID: 39071736 PMC: 11275453. DOI: 10.1093/noajnl/vdae065.

Diffuse glioma molecular profiling with arterial spin labeling and dynamic susceptibility contrast perfusion MRI: A comparative study.

Prysiazhniuk Y, Server A, Leske H, Bech-Aase O, Helseth E, Eijgelaar R Neurooncol Adv. 2024; 6(1):vdae113.

PMID: 39036439 PMC: 11259011. DOI: 10.1093/noajnl/vdae113.

References

Takano S . Glioblastoma angiogenesis: VEGF resistance solutions and new strategies based on molecular mechanisms of tumor vessel formation. Brain Tumor Pathol. 2012; 29(2):73-86. DOI: 10.1007/s10014-011-0077-6. View

Kapoor G, Gocke T, Chawla S, Whitmore R, Nabavizadeh A, Krejza J . Magnetic resonance perfusion-weighted imaging defines angiogenic subtypes of oligodendroglioma according to 1p19q and EGFR status. J Neurooncol. 2009; 92(3):373-86. DOI: 10.1007/s11060-009-9880-x. View

Boxerman J, Quarles C, Hu L, Erickson B, Gerstner E, Smits M . Consensus recommendations for a dynamic susceptibility contrast MRI protocol for use in high-grade gliomas. Neuro Oncol. 2020; 22(9):1262-1275. PMC: 7523451. DOI: 10.1093/neuonc/noaa141. View

Hilario A, Hernandez-Lain A, Sepulveda J, Lagares A, Perez-Nunez A, Ramos A . Perfusion MRI grading diffuse gliomas: Impact of permeability parameters on molecular biomarkers and survival. Neurocirugia (Astur : Engl Ed). 2018; 30(1):11-18. DOI: 10.1016/j.neucir.2018.06.004. View

Zhang L, Kundu S, Feenstra T, Li X, Jin C, Laaniste L . Pleiotrophin promotes vascular abnormalization in gliomas and correlates with poor survival in patients with astrocytomas. Sci Signal. 2015; 8(406):ra125. DOI: 10.1126/scisignal.aaa1690. View

Eriksen M, Frandsen T . The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: a systematic review. J Med Libr Assoc. 2018; 106(4):420-431. PMC: 6148624. DOI: 10.5195/jmla.2018.345. View

Louis D, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee W . The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016; 131(6):803-20. DOI: 10.1007/s00401-016-1545-1. View

Lecavalier-Barsoum M, Quon H, Abdulkarim B . Adjuvant treatment of anaplastic oligodendrogliomas and oligoastrocytomas. Cochrane Database Syst Rev. 2014; (5):CD007104. PMC: 7388823. DOI: 10.1002/14651858.CD007104.pub2. View

Madden S, Cook B, Nacht M, Weber W, Callahan M, Jiang Y . Vascular gene expression in nonneoplastic and malignant brain. Am J Pathol. 2004; 165(2):601-8. PMC: 1618572. DOI: 10.1016/s0002-9440(10)63324-x. View

10.

Xing Z, Yang X, She D, Lin Y, Zhang Y, Cao D . Noninvasive Assessment of Mutational Status in World Health Organization Grade II and III Astrocytomas Using DWI and DSC-PWI Combined with Conventional MR Imaging. AJNR Am J Neuroradiol. 2017; 38(6):1138-1144. PMC: 7960080. DOI: 10.3174/ajnr.A5171. View

11.

Zhang L, He L, Lugano R, Roodakker K, Bergqvist M, Smits A . IDH mutation status is associated with distinct vascular gene expression signatures in lower-grade gliomas. Neuro Oncol. 2018; 20(11):1505-1516. PMC: 6176806. DOI: 10.1093/neuonc/noy088. View

12.

Lee J, Ahn K, Lee Y, Jang J, Jung S, Kim B . Differentiation of grade II and III oligodendrogliomas from grade II and III astrocytomas: a histogram analysis of perfusion parameters derived from dynamic contrast-enhanced (DCE) and dynamic susceptibility contrast (DSC) MRI. Acta Radiol. 2017; 59(6):723-731. DOI: 10.1177/0284185117728981. View

13.

Wang X, Cao M, Chen H, Ge J, Suo S, Zhou Y . Simplified perfusion fraction from diffusion-weighted imaging in preoperative prediction of IDH1 mutation in WHO grade II-III gliomas: comparison with dynamic contrast-enhanced and intravoxel incoherent motion MRI. Radiol Oncol. 2020; 54(3):301-310. PMC: 7409598. DOI: 10.2478/raon-2020-0037. View

14.

LaPointe S, Perry A, Butowski N . Primary brain tumours in adults. Lancet. 2018; 392(10145):432-446. DOI: 10.1016/S0140-6736(18)30990-5. View

15.

van Kempen E, Post M, Mannil M, Kusters B, Laan M, Meijer F . Accuracy of Machine Learning Algorithms for the Classification of Molecular Features of Gliomas on MRI: A Systematic Literature Review and Meta-Analysis. Cancers (Basel). 2021; 13(11). PMC: 8198025. DOI: 10.3390/cancers13112606. View

16.

Welker K, Boxerman J, Kalnin A, Kaufmann T, Shiroishi M, Wintermark M . ASFNR recommendations for clinical performance of MR dynamic susceptibility contrast perfusion imaging of the brain. AJNR Am J Neuroradiol. 2015; 36(6):E41-51. PMC: 5074767. DOI: 10.3174/ajnr.A4341. View

17.

Pen A, Moreno M, Martin J, Stanimirovic D . Molecular markers of extracellular matrix remodeling in glioblastoma vessels: microarray study of laser-captured glioblastoma vessels. Glia. 2007; 55(6):559-72. DOI: 10.1002/glia.20481. View

18.

Hempel J, Schittenhelm J, Klose U, Bender B, Bier G, Skardelly M . In Vivo Molecular Profiling of Human Glioma : Cross-Sectional Observational Study Using Dynamic Susceptibility Contrast Magnetic Resonance Perfusion Imaging. Clin Neuroradiol. 2018; 29(3):479-491. DOI: 10.1007/s00062-018-0676-2. View

19.

Wang N, Xie S, Liu H, Chen G, Zhang W . Arterial Spin Labeling for Glioma Grade Discrimination: Correlations with IDH1 Genotype and 1p/19q Status. Transl Oncol. 2019; 12(5):749-756. PMC: 6423366. DOI: 10.1016/j.tranon.2019.02.013. View

20.

Whitmore R, Krejza J, Kapoor G, Huse J, Woo J, Bloom S . Prediction of oligodendroglial tumor subtype and grade using perfusion weighted magnetic resonance imaging. J Neurosurg. 2007; 107(3):600-9. DOI: 10.3171/JNS-07/09/0600. View