TY - JOUR
T1 - Prediction of H3K27M Alteration Status in Brainstem Glioma Using Multi-Shell Diffusion MRI Metrics
AU - Xu, Xiaolu
AU - Zhang, Peng
AU - Zhuo, Zhizheng
AU - Duan, Yunyun
AU - Qu, Liying
AU - Cheng, Dan
AU - Sun, Ting
AU - Ding, Jinli
AU - Xie, Cong
AU - Liu, Xing
AU - Haller, Sven
AU - Barkhof, Frederik
AU - Ye, Chuyang
AU - Zhang, Liwei
AU - Liu, Yaou
N1 - Funding Information: Yaou Liu was supported by the National Science Foundation of China (81870958), the Beijing Municipal Natural Science Foundation for Distinguished Young Scholars (JQ20035), the Special Fund of the Pediatric Medical Coordinated Development Center of Beijing Hospitals Authority (XTYB201831). Frederik Barkhof was supported by the NIHR biomedical research center at UCLH. Publisher Copyright: © 2023 International Society for Magnetic Resonance in Medicine.
PY - 2023
Y1 - 2023
N2 - Background: Multi-shell diffusion characteristics may help characterize brainstem gliomas (BSGs) and predict H3K27M status. Purpose: To identify the diffusion characteristics of BSG patients and investigate the predictive values of various diffusion metrics for H3K27M status in BSG. Study Type: Prospective. Population: Eighty-four BSG patients (median age 10.5 years [IQR 6.8–30.0 years]) were included, of whom 56 were pediatric and 28 were adult patients. Field Strength/Sequence: 3 T, multi-shell diffusion imaging. Assessment: Diffusion kurtosis imaging and neurite orientation dispersion and density imaging analyses were performed. Age, gender, and diffusion metrics, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity, radial diffusivity (RD), mean kurtosis (MK), axial kurtosis (AK), radial kurtosis, intracellular volume fraction (ICVF), orientation dispersion index, and isotropic volume fraction (ISOVF), were compared between H3K27M-altered and wildtype BSG patients. Statistical Tests: Chi-square test, Mann–Whitney U test, multivariate analysis of variance (MANOVA), step-wise multivariable logistic regression. P-values <0.05 were considered significant. Results: 82.4% pediatric and 57.1% adult patients carried H3K27M alteration. In the whole group, the H3K27M-altered BSGs demonstrated higher FA, AK and lower RD, ISOVF. The combination of age and median ISOVF showed fair performance for H3K27M prediction (AUC = 0.78). In the pediatric group, H3K27M-altered BSGs showed higher FA, AK, MK, ICVF and lower RD, MD, ISOVF. The combinations of median ISOVF, 5th percentile of FA, median MK and median MD showed excellent predictive power (AUC = 0.91). In the adult group, H3K27M-altered BSGs showed higher ICVF and lower RD, MD. The 75th percentile of RD demonstrated fair performance for H3K27M status prediction (AUC = 0.75). Data Conclusion: Different alteration patterns of diffusion measures were identified between H3K27M-altered and wildtype BSGs, which collectively had fair to excellent predictive value for H3K27M alteration status, especially in pediatric patients. Evidence Level: 2. Technical Efficacy: Stage 3.
AB - Background: Multi-shell diffusion characteristics may help characterize brainstem gliomas (BSGs) and predict H3K27M status. Purpose: To identify the diffusion characteristics of BSG patients and investigate the predictive values of various diffusion metrics for H3K27M status in BSG. Study Type: Prospective. Population: Eighty-four BSG patients (median age 10.5 years [IQR 6.8–30.0 years]) were included, of whom 56 were pediatric and 28 were adult patients. Field Strength/Sequence: 3 T, multi-shell diffusion imaging. Assessment: Diffusion kurtosis imaging and neurite orientation dispersion and density imaging analyses were performed. Age, gender, and diffusion metrics, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity, radial diffusivity (RD), mean kurtosis (MK), axial kurtosis (AK), radial kurtosis, intracellular volume fraction (ICVF), orientation dispersion index, and isotropic volume fraction (ISOVF), were compared between H3K27M-altered and wildtype BSG patients. Statistical Tests: Chi-square test, Mann–Whitney U test, multivariate analysis of variance (MANOVA), step-wise multivariable logistic regression. P-values <0.05 were considered significant. Results: 82.4% pediatric and 57.1% adult patients carried H3K27M alteration. In the whole group, the H3K27M-altered BSGs demonstrated higher FA, AK and lower RD, ISOVF. The combination of age and median ISOVF showed fair performance for H3K27M prediction (AUC = 0.78). In the pediatric group, H3K27M-altered BSGs showed higher FA, AK, MK, ICVF and lower RD, MD, ISOVF. The combinations of median ISOVF, 5th percentile of FA, median MK and median MD showed excellent predictive power (AUC = 0.91). In the adult group, H3K27M-altered BSGs showed higher ICVF and lower RD, MD. The 75th percentile of RD demonstrated fair performance for H3K27M status prediction (AUC = 0.75). Data Conclusion: Different alteration patterns of diffusion measures were identified between H3K27M-altered and wildtype BSGs, which collectively had fair to excellent predictive value for H3K27M alteration status, especially in pediatric patients. Evidence Level: 2. Technical Efficacy: Stage 3.
KW - H3K27M alteration
KW - brainstem glioma
KW - diffusion kurtosis imaging
KW - multi-shell diffusion
KW - neurite orientation dispersion and density imaging
UR - http://www.scopus.com/inward/record.url?scp=85175017223&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/jmri.29104
DO - https://doi.org/10.1002/jmri.29104
M3 - Article
C2 - 37889147
SN - 1053-1807
JO - Journal of magnetic resonance imaging
JF - Journal of magnetic resonance imaging
ER -