In vivo molecular profiling of human glioma using diffusion kurtosis imaging
In vivo molecular profiling of human glioma using diffusion kurtosis imaging
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DOI：
10.1007/s11060-016-2272-0
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发表时间：
2017-01-01
影响因子：
3.9
通讯作者：
Klose, Uwe
中科院分区：
文献类型：
--
作者：
Hempel, Johann-Martin;Bisdas, Sotirios;Klose, Uwe
本研究的目的是评估扩散峰度成像（DKI）在人脑胶质瘤体内分子谱分析中的诊断性能。在50例经组织病理学证实的胶质瘤患者中评估了DKI的标准化平均峰度（MKn）和平均扩散率（MDn）指标。比较了基于WHO的组织学检查结果和导致综合诊断的分子特征（哈勒姆共识）：异柠檬酸脱氢酶（IDH 1/2）突变状态、α地中海贫血/智力低下综合征X连锁（ATRX）表达、染色体1 p/19 q杂合性缺失（洛）和O 6-甲基鸟嘌呤DNA甲基转移酶（MGMT）启动子甲基化状态。与IDH 1/2野生型（0.57 +/-0.09，p < 0.001）和ATRX维持表达（0.51 +/-0.10，p = 0.004）的肿瘤相比，IDH 1/2突变（0.43 +/-0.09）和ATRX表达缺失（0.41 +/-0.11）的肿瘤中的MKn显著更低。在综合分子诊断方面，MKn在原发性胶质母细胞瘤（0.57 ± 0.10）中显著高于星形细胞瘤（0.39 ± 0.11，p < 0.001）和少突胶质细胞瘤（0.47 ± 0.05，p = 0.003）。MK可用于提供关于IDH 1/2突变状态和ATRX表达的人类胶质瘤分子谱的洞察。考虑到这些分子标志物的诊断和预后意义，MK似乎是一个有前途的胶质瘤体内生物标志物。MK的诊断性能似乎更适合于整合分子方法，而不是目前WHO 2007分类的常规组织学结果。
The purpose of this study is to assess the diagnostic performance of diffusion kurtosis imaging (DKI) for in vivo molecular profiling of human glioma. Normalized mean kurtosis (MKn) and mean diffusivity (MDn) metrics from DKI were assessed in 50 patients with histopathologically confirmed glioma. The results were compared in regard to the WHO-based histological findings and molecular characteristics leading to integrated diagnosis (Haarlem Consensus): isocitrate-dehydrogenase (IDH1/2) mutation status, alpha-thalassemia/mental retardation syndrome X-linked (ATRX) expression, chromosome 1p/19q loss of heterozygosity (LOH), and O6-methylguanine DNA methyltransferase (MGMT) promoter methylation status. MKn was significantly lower in tumors with IDH1/2 mutation (0.43 +/- 0.09) and ATRX loss of expression (0.41 +/- 0.11) than in those with IDH1/2 wild type (0.57 +/- 0.09, p < 0.001) and ATRX maintained expression (0.51 +/- 0.10, p = 0.004), respectively. Regarding the integrated molecular diagnosis, MKn was significantly higher in primary glioblastoma (0.57 +/- 0.10) than in astrocytoma (0.39 +/- 0.11, p < 0.001) and oligodendroglioma (0.47 +/- 0.05, p = 0.003). MK may be used to provide insight into the human glioma molecular profile regarding IDH1/2 mutation status and ATRX expression. Considering the diagnostic and prognostic significance of these molecular markers, MK appears to be a promising in vivo biomarker for glioma. The diagnostic performance of MK seems to fit more with the integrated molecular approach than the conventional histological findings of the current WHO 2007 classification.