Nicholas Sung-Jin Cho (University of California, Los Angeles) | 한빛사논문 > 한빛사

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조회237

University of California, Los Angeles

Neuro-Oncology, Published: 28 August 2025 | https://doi.org/10.1093/neuonc/noaf171 Perfusion, diffusion, and anatomical MRI characteristics of pathologically-confirmed malignant transformation in IDH-mutant gliomas

Nicholas S Cho ^1,2,3,4, Viên Lam Le^1,2,3, Ashley Teraishi ^1,2, Vicki Liu ^5,6, Francesco Sanvito ^1,2, Donatello Telesca ⁷, Masanori Nakajo ^1,2, Chencai Wang ^1,2, Sonoko Oshima ^1,2, Blaine S C Eldred^5,6, Jingwen Yao ^1,2, Phioanh L Nghiemphu ^5,6, Noriko Salamon², Timothy F Cloughesy ^5,6, Albert Lai ^5,6, Benjamin M Ellingson ^8,9

¹UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, USA.
²Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
³Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, Los Angeles, CA, USA.
⁴Medical Scientist Training Program, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
⁵UCLA Neuro-Oncology Program, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
⁶Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
⁷Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.
⁸Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
⁹Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.

Corresponding author: Benjamin M. Ellingson, Ph.D.

Abstract

Background: This study explored MRI characteristics at the time of tumor progression to study pathologically-confirmed MT in IDHm 1p/19q-intact astrocytomas (IDHm-A) and IDHm 1p/19q-co-deleted oligodendrogliomas (IDHm-O).

Methods: N=64 patients with initial pathological grade 2 IDH-mutant glioma diagnosis who underwent repeated tissue sampling and were classified as pathologically-confirmed MT (n=35) or non-MT (n=29) with available pre-surgical anatomical (n=64), diffusion-weighted (n=61), and dynamic susceptibility contrast perfusion MRI (n=53) were retrospectively studied. Measurable contrast enhancement (>1000mm3), tumor volume, tumor growth rate, sphericity, median apparent diffusion coefficient (ADC), and normalized relative cerebral blood volume (nrCBV) were compared between MT vs. non-MT IDHm-A and IDHm-O.

Results: 81% of contrast-enhancing IDHm-A and 100% of contrast-enhancing IDHm-O demonstrated MT, while 41% of IDHm-A and 62% IDHm-O exhibited both non-enhancing tumor progression and MT. Tumor volumes were significantly larger in patients with MT compared to non-MT groups for IDHm-A (P=0.02) and IDHm-O (P=0.04). T2/FLAIR tumor volume growth rate was significantly higher (P=0.003), nrCBV was significantly higher (P=0.002), and ADC trended lower (P=0.06) in MT vs. non-MT IDHm-A. There were no significant differences in growth rate, ADC, nrCBV, or sphericity when comparing MT vs. non-MT IDHm-O (P>0.05).

Conclusions: Many MT IDHm gliomas remain non-enhancing. Growth rate, diffusion, and perfusion MRI show differences between MT and non-MT in IDHm-A but not IDHm-O, which may reflect the different tumor biology of these IDHm molecular subtypes and their need for separate imaging biomarkers. Tumor volumes can help determine MT for both IDHm-A and IDHm-O.

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