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The Cortical High-flow Sign of Oligodendroglioma, IDH-mutant and 1p/19q-codeleted: Comparison Between Arterial Spin Labeling and Dynamic Susceptibility Contrast Methods

Overview
Journal Neuroradiology
Specialties Neurology
Radiology
Date 2023 Dec 21
PMID 38127124
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Abstract

Purpose: The cortical high-flow sign with the non-enhancing area was reportedly found to be more frequent with oligodendroglioma, IDH-mutant and 1p/19q codeleted (ODG IDHm-codel) than with IDH-wildtype or astrocytoma, IDH-mutant on arterial spin labeling (ASL) in diffuse gliomas. This study aimed to compare the identification rate of the cortical high-flow sign on ASL in patients with ODG IDHm-codel to that on dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI).

Methods: Participants consisted of 32 adult ODG IDHm-codel patients with pathologically confirmed. Subtraction images were generated from paired control and label images on ASL. For DSC, dynamic T2*-weighted perfusion weighted images were obtained after pre-bolus of gadolinium-based contrast agent. Regional cerebral blood flow/volume maps were generated based on the concentration-time curve and arterial input function. Tumor-affecting cortices without contrast enhancement on conventional MR imaging were targeted. The identification rate of the cortical high-flow sign was compared between ASL and DSC using the Pearson's Chi-Square test.

Results: Frequency of the cortical high-flow sign was significantly higher on ASL (18/32, 56.3%; p < 0.001) than on DSC (5/32, 15.6%). All cases with the positive cortical high-flow sign on DSC were identified on ASL.

Conclusion: ASL effectively identifies the cortical high-flow sign in ODG IDHm-codel, surpassing DSC in identification rates.

Citing Articles

The cortical high-flow sign in oligodendroglioma, IDH-mutant and 1p/19q-codeleted is correlated with histological cortical vascular density.

Yamashita K, Murayama R, Itoyama M, Kikuchi K, Kusunoki M, Kuga D Neuroradiology. 2025; 67(2):291-298.

PMID: 39831960 DOI: 10.1007/s00234-024-03538-1.


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.

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