Diffusion and perfusion MRI may predict EGFR amplification and the TERT promoter mutation status of IDH-wildtype lower-grade gliomas
Diffusion and perfusion MRI may predict EGFR amplification and the TERT promoter mutation status of IDH-wildtype lower-grade gliomas
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DOI：
10.1007/s00330-020-07090-3
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发表时间：
2020-08-12
影响因子：
5.9
通讯作者：
Lee, Seung-Koo
中科院分区：
文献类型：
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作者：
Park, Yae Won;Ahn, Sung Soo;Lee, Seung-Koo
目的 异柠檬酸脱氢酶野生型 (IDHwt) 低级别胶质瘤 (LGG；II/III 级) 的表皮生长因子受体 (EGFR) 扩增和端粒酶逆转录酶启动子 (TERTp) 突变状态对于识别具有侵袭性临床病程的 IDHwt LGG 至关重要。本研究的目的是评估扩散张量成像、动态磁化率对比 (DSC) 和扩散张量成像的参数是否存在。动态对比增强成像可以预测 IDHwt LGG 的 EGFR 扩增和 TERTp 突变状态。 方法 对 49 例已知 EGFR 扩增（39 个非扩增，10 个扩增）或 TERTp 突变（19 个野生型，21 个突变）状态的 IDHwt LGG 患者进行 MRI。评估平均 ADC、分数各向异性 (FA)、标准化脑血容量 (nCBV)、标准化脑血流量 (nCBF)、容量转移常数 (K-trans)、速率转移系数 (K-ep)、血管外细胞外体积分数 (V-e) 和血浆体积分数 (V-p) 值。构建了单变量和多变量逻辑回归模型。结果 EGFR 扩增肿瘤的平均 ADC 值低于 EGFR 非扩增肿瘤（p = 0.019）。平均 ADC 是 EGFR 扩增的独立预测因子，AUC 为 0.75。与 TERTp 野生型肿瘤相比，TERTp 突变型肿瘤表现出较高的平均 nCBV (p = 0.020)、较高的平均 nCBF (p = 0.017) 和较高的平均 V-p (p = 0.002)。通过多变量逻辑回归，平均 V-p 是 TERTp 突变状态的独立预测因子，AUC 为 0.85。 结论 这项探索性试点研究表明，较低的 ADC 值可能有助于预测 EGFR 扩增，而较高的 V-p 值可能有助于预测 IDHwt LGG 的 TERTp 突变状态。
Objectives Epidermal growth factor receptor (EGFR) amplification and telomerase reverse transcriptase promoter (TERTp) mutation status of isocitrate dehydrogenase-wildtype (IDHwt) lower-grade gliomas (LGGs; grade II/III) are crucial for identifying IDHwt LGG with an aggressive clinical course. The purpose of this study was to assess whether parameters from diffusion tensor imaging, dynamic susceptibility contrast (DSC), and diffusion tensor imaging. dynamic contrast-enhanced imaging can predict the EGFR amplification and TERTp mutation status of IDHwt LGGs.Methods A total of 49 patients with IDHwt LGGs with either known EGFR amplification (39 non-amplified, 10 amplified) or TERTp mutation (19 wildtype, 21 mutant) statuses underwent MRI. The mean ADC, fractional anisotropy (FA), normalized cerebral blood volume (nCBV), normalized cerebral blood flow (nCBF), volume transfer constant (K-trans), rate transfer coefficient (K-ep), extravascular extracellular volume fraction (V-e), and plasma volume fraction (V-p) values were assessed. Univariate and multivariate logistic regression models were constructed.Results EGFR-amplified tumors showed lower mean ADC values than EGFR-non-amplified tumors (p = 0.019). Mean ADC was an independent predictor of EGFR amplification, with an AUC of 0.75. TERTp mutant tumors showed higher mean nCBV (p = 0.020), higher mean nCBF (p = 0.017), and higher mean V-p (p = 0.002) than TERTp wildtype tumors. With multivariate logistic regression, mean V-p was the independent predictor of TERTp mutation status, with an AUC of 0.85.Conclusion This exploratory pilot study shows that lower ADC values may be useful for prediction of EGFR amplification, whereas higher V-p values may be useful for prediction of the TERTp mutation status of IDHwt LGGs.