{"doi":"10.1007/s00234-024-03475-z","title":"Diffusion MRI is superior to quantitative T2-FLAIR mismatch in predicting molecular subtypes of human non-enhancing gliomas","abstract":"PURPOSE: This study compared the classification performance of normalized apparent diffusion coefficient (nADC) with percentage T2-FLAIR mismatch-volume (%T2FM-volume) for differentiating between IDH-mutant astrocytoma (IDHm-A) and other glioma molecular subtypes. METHODS: A total of 105 non-enhancing gliomas were studied. T2-FLAIR digital subtraction maps were used to identify T2FM and T2-FLAIR non-mismatch (T2FNM) subregions within tumor volumes of interest (VOIs). Median nADC from the whole tumor, T2FM, and T2NFM subregions and %T2FM-volume were obtained. IDHm-A classification analyses using receiver-operating characteristic curves and multiple logistic regression were performed in addition to exploratory survival analyses. RESULTS: T2FM subregions had significantly higher nADC than T2FNM subregions within IDHm-A with ≥ 25% T2FM-volume (P < 0.0001). IDHm-A with ≥ 25% T2FM-volume demonstrated significantly higher whole tumor nADC compared to IDHm-A with < 25% T2FM-volume (P < 0.0001), and both IDHm-A subgroups demonstrated significantly higher nADC compared to IDH-mutant oligodendroglioma and IDH-wild-type gliomas (P < 0.05). For classification of IDHm-A vs. other gliomas, the area under curve (AUC) of nADC was significantly greater compared to the AUC of %T2FM-volume (P = 0.01, nADC AUC = 0.848, %T2FM-volume AUC = 0.714) along with greater sensitivity. In exploratory survival analyses within IDHm-A, %T2FM-volume was not associated with overall survival (P = 0.2), but there were non-significant trends for nADC (P = 0.07) and tumor volume (P = 0.051). CONCLUSION: T2-FLAIR subtraction maps are useful for characterizing IDHm-A imaging characteristics. nADC outperforms %T2FM-volume for classifying IDHm-A amongst non-enhancing gliomas with preserved high specificity and increased sensitivity, which may be related to inherent diffusivity differences regardless of T2FM. In line with previous findings on visual T2FM-sign, quantitative %T2FM-volume may not be prognostic.","journal":"Neuroradiology","year":2024,"id":458534,"datarank":0.26876392038420827,"base_score":1.791759469228055,"endowment":1.791759469228055,"self_citation_contribution":0.26876392038420827,"citation_network_contribution":0.0,"self_endowment_contribution":0.26876392038420827,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9486,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":954924,"name":"Francesco Sanvito","orcid":"0000-0003-3379-9958","position":1,"is_corresponding":false},{"id":411313,"name":"Vien Le","orcid":"0000-0003-2933-332X","position":2,"is_corresponding":false},{"id":1098637,"name":"Sonoko Oshima","orcid":"0000-0002-1453-3807","position":3,"is_corresponding":false},{"id":1230466,"name":"Ashley Teraishi","orcid":"0009-0004-3442-8109","position":4,"is_corresponding":false},{"id":396762,"name":"Jingwen Yao","orcid":"0000-0002-8828-1841","position":5,"is_corresponding":false},{"id":1071581,"name":"Donatello Telesca","orcid":"0000-0003-0773-451X","position":6,"is_corresponding":false},{"id":396763,"name":"Catalina Raymond","orcid":"0000-0003-2757-439X","position":7,"is_corresponding":false},{"id":297477,"name":"Whitney B. Pope","orcid":"0000-0003-4803-1992","position":8,"is_corresponding":false},{"id":396768,"name":"Phioanh L. Nghiemphu","orcid":"0000-0003-4064-6079","position":9,"is_corresponding":false},{"id":297478,"name":"Albert Lai","orcid":"0000-0002-7265-2986","position":10,"is_corresponding":false},{"id":397177,"name":"Noriko Salamon","orcid":"0000-0002-3520-9467","position":11,"is_corresponding":false},{"id":247467,"name":"Timothy F. Cloughesy","orcid":"0000-0002-8656-7483","position":12,"is_corresponding":false},{"id":247468,"name":"Benjamin M. Ellingson","orcid":"0000-0002-2764-6640","position":13,"is_corresponding":false},{"id":443406,"name":"Nicholas S. Cho","orcid":"0000-0002-8686-0575","position":0,"is_corresponding":true}],"reference_count":38,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:03:50.608887Z","pmid":"39377927","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}