Preoperative MRI enhancement grade for adult diffuse glioma affects IDH mutation and WHO grade

Abstract

Objective To analyze the clinical features and magnetic resonance imaging (MRI) features of adult diffuse glioma, define the preoperative MRI enhancement grade (ET grade) of the disease, and explore the relationship of ET grade with isocitrate dehydrogenase (IDH) mutation and WHO grade. Methods The clinical data of 306 cases of adult diffuse glioma confirmed by surgery and pathology admitted in our hospital from January 2018 to December 2023 were collected and retrospectively analyzed. There were 169 cases of mutant IDH and 137 cases of wildtype IDH. The differences in gender, age, MRI signal uniformity, clear tumor margin, obvious edema, compression of adjacent ventricles and ET grade were analyzed between the 2 types of IDH patients. A logistic regression model was established to identify the independent influencing factors for IDH mutation, and the correlation of ET grade with IDH status and WHO grade was analyzed. Results There were significant differences in age, whether the MRI signal was uniform, whether the tumor margin was clear, whether the edema was obvious, the compression of the adjacent ventricle and the ET grade in patients with different IDH status. The independent variables were screened by Forward method and then included in the logistic regression model. ET grade, age and tumor margin were independent influencing factors of IDH mutation status and negatively correlated with IDH mutation. For every 1 year increase in age, the probability of mutant IDH in adult diffuse glioma was decreased by 0.93 times. The accuracy of the established regression model for predicting IDH status was 0.859, the sensitivity was 0.852, the specificity was 0.869, and the AUC value was 0.922 (0.892~0.952). ET grade was significantly correlated with WHO grade. The most prominent proportion of glioma patients with WHO grade 2 was noET, that with WHO grade 3 was ET2, and that with WHO grade 4 was ET3. Conclusion For adult diffuse glioma, preoperative MRI ET grade is negatively correlated with IDH mutation status, and positively with WHO grade. ET grade is helpful for determination of of IDH mutation status and WHO grade.

Keywords

• adult diffuse glioma
• enhancement grade
• magnetic resonance imaging
• idh mutant
• who grade