Diagnostic performance of multiparametric nonenhanced magnetic resonance imaging (MRI) in grading glioma and correlating IDH mutation status.

Objective: To evaluate the diagnostic performance of nonenhanced magnetic resonance imaging (MRI) in grading glioma and correlating isocitrate dehydrogenase (IDH) mutation status.

Methods: Patients with diagnoses confirmed by postoperative pathology were enrolled. Quantitative parameters, including the relative amide proton transfer-weighted (rAPTW), relative cerebral blood flow (CBF), and apparent diffusion coefficient (ADC) were applied to grade gliomas and correlate IDH mutation status. MRI parameters were compared with an independent-sample t-test. The diagnostic performance was assessed and compared with a receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC).

Results: The rAPTW signal and rCBF values were significantly higher in high-grade gliomas (HGG) than in low-grade glioma (LGG), whereas ADC values were significantly lower in HGG than in LGG. Compared with 3D-pCASL imaging and diffusion-weighted imaging (DWI), 3D-APTW imaging had the best diagnostic performance in distinguishing LGG from HGG, with an AUC of 0.930, a sensitivity of 91.2% and a specificity of 87.5%. By adding 3D-APTW imaging to 3D-pCASL imaging, or DWI, the diagnostic performance of both sequences increased. Furthermore, APTW, rAPTW, CBF, and rCBF values in the IDH mutant-type (IDH-mut) group were significantly lower than those in the IDH wild-type (IDH-wt) group, ADC values were significantly higher in IDH-mut group than in IDH-wt group.

Conclusions: 3D-APTW imaging demonstrated better diagnostic performance than DWI or 3D-pCASL imaging in grading gliomas. Moreover, 3D-APTW imaging had added value in addition to both 3D-pCASL imaging and DWI in distinguishing LGG from HGG. 3D-APTW, 3D-pCASL, and DWI imaging could be used to discriminate between IDH-mut and IDH-wt group.