{"title":"评估 IDH 突变状态对胶质瘤患者白质完整性 MRI 评估的影响：从骨架化平均扩散率峰值宽度和自由水指标中获得的启示","authors":"Yuanhao Li, Hongquan Zhu, Yufei Liu, Yujie Ding, Shihui Li, Li Li, Jiaxuan Zhang, Jingjing Jiang, Nanxi Shen, Wenzhen Zhu","doi":"10.1002/jmri.29561","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Gliomas are highly invasive brain tumors that evade accurate geographic assessment by conventional MRI due to microscopic invasion along white matter (WM) tracts. Advanced diffusion MRI techniques are needed to assess occult WM involvement.</p><p><strong>Purpose: </strong>To evaluate peak width of skeletonized mean diffusivity (PSMD) and peak width of skeletonized free water (PSFW), and axonal water fraction (AWF) for assessing glioma-induced alterations in normal-appearing WM and their relationship with isocitrate dehydrogenase 1 (IDH1) mutation.</p><p><strong>Study type: </strong>Retrospective.</p><p><strong>Population: </strong>One hundred five glioma patients (46 ± 13 years), 53 healthy controls (HCs) (46 ± 9 years).</p><p><strong>Field strength/sequence: </strong>3.0 T, T1WI, T1-CE, T2WI, T2FLAIR, and DKI.</p><p><strong>Assessment: </strong>PSMD and PSFW were compared between lesion and contralateral sides in glioma patients and between patients and HCs. The associations between these metrics and clinical variables, including IDH1 mutation, was assessed. Corpus callosum (CC) injury, quantified by the AWF, was evaluated for its mediated effect of IDH1 mutation on contralesional PSMD and PSFW.</p><p><strong>Statistical tests: </strong>Paired-t tests, ANCOVA, univariate and multivariate linear regression, and mediation analysis with significance set at P < 0.05.</p><p><strong>Results: </strong>Contralateral PSMD and PSFW were significantly higher in left-sided gliomas (PSMD: 0.206 ± 0.027 vs. 0.193 ± 0.023; PSFW: 0.119 ± 0.019 vs. 0.106 ± 0.020) than in HCs, with similar increases in right-sided gliomas (PSMD: 0.219 ± 0.036 vs. 0.195 ± 0.023; PSFW: 0.129 ± 0.031 vs. 0.109 ± 0.020). IDH1 wild-type gliomas were associated with higher contralateral PSMD and PSFW (β = -0.302 and -0.412). AWF of CC mediated the impact of IDH1 mutations on contralesional PSMD and PSFW (mediated proportion: 42.7% and 53.7%).</p><p><strong>Data conclusion: </strong>PSMD and PSFW are effective biomarkers for assessing WM integrity in gliomas, significantly associated with IDH1 mutation status. AWF of CC mediates the relationship between IDH1 mutation and contralesional PSMD and PSFW.</p><p><strong>Evidence level: </strong>4 TECHNICAL EFFICACY: Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":null,"pages":null},"PeriodicalIF":3.3000,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessment the Impact of IDH Mutation Status on MRI Assessments of White Matter Integrity in Glioma Patients: Insights From Peak Width of Skeletonized Mean Diffusivity and Free Water Metrics.\",\"authors\":\"Yuanhao Li, Hongquan Zhu, Yufei Liu, Yujie Ding, Shihui Li, Li Li, Jiaxuan Zhang, Jingjing Jiang, Nanxi Shen, Wenzhen Zhu\",\"doi\":\"10.1002/jmri.29561\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Gliomas are highly invasive brain tumors that evade accurate geographic assessment by conventional MRI due to microscopic invasion along white matter (WM) tracts. Advanced diffusion MRI techniques are needed to assess occult WM involvement.</p><p><strong>Purpose: </strong>To evaluate peak width of skeletonized mean diffusivity (PSMD) and peak width of skeletonized free water (PSFW), and axonal water fraction (AWF) for assessing glioma-induced alterations in normal-appearing WM and their relationship with isocitrate dehydrogenase 1 (IDH1) mutation.</p><p><strong>Study type: </strong>Retrospective.</p><p><strong>Population: </strong>One hundred five glioma patients (46 ± 13 years), 53 healthy controls (HCs) (46 ± 9 years).</p><p><strong>Field strength/sequence: </strong>3.0 T, T1WI, T1-CE, T2WI, T2FLAIR, and DKI.</p><p><strong>Assessment: </strong>PSMD and PSFW were compared between lesion and contralateral sides in glioma patients and between patients and HCs. The associations between these metrics and clinical variables, including IDH1 mutation, was assessed. Corpus callosum (CC) injury, quantified by the AWF, was evaluated for its mediated effect of IDH1 mutation on contralesional PSMD and PSFW.</p><p><strong>Statistical tests: </strong>Paired-t tests, ANCOVA, univariate and multivariate linear regression, and mediation analysis with significance set at P < 0.05.</p><p><strong>Results: </strong>Contralateral PSMD and PSFW were significantly higher in left-sided gliomas (PSMD: 0.206 ± 0.027 vs. 0.193 ± 0.023; PSFW: 0.119 ± 0.019 vs. 0.106 ± 0.020) than in HCs, with similar increases in right-sided gliomas (PSMD: 0.219 ± 0.036 vs. 0.195 ± 0.023; PSFW: 0.129 ± 0.031 vs. 0.109 ± 0.020). IDH1 wild-type gliomas were associated with higher contralateral PSMD and PSFW (β = -0.302 and -0.412). AWF of CC mediated the impact of IDH1 mutations on contralesional PSMD and PSFW (mediated proportion: 42.7% and 53.7%).</p><p><strong>Data conclusion: </strong>PSMD and PSFW are effective biomarkers for assessing WM integrity in gliomas, significantly associated with IDH1 mutation status. AWF of CC mediates the relationship between IDH1 mutation and contralesional PSMD and PSFW.</p><p><strong>Evidence level: </strong>4 TECHNICAL EFFICACY: Stage 2.</p>\",\"PeriodicalId\":16140,\"journal\":{\"name\":\"Journal of Magnetic Resonance Imaging\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2024-08-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Magnetic Resonance Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jmri.29561\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Magnetic Resonance Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jmri.29561","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
背景：胶质瘤是一种高侵袭性脑肿瘤，由于沿白质（WM）束的微小侵袭，传统磁共振成像无法对其进行准确的地理评估。目的：评估骨架化平均扩散率峰值宽度（PSMD）、骨架化自由水峰值宽度（PSFW）和轴突水分数（AWF），以评估胶质瘤诱发的正常外观WM改变及其与异柠檬酸脱氢酶1（IDH1）突变的关系：研究类型：回顾性研究：15名胶质瘤患者（46 ± 13岁），53名健康对照组（HCs）（46 ± 9岁）：场强/序列：3.0 T、T1WI、T1-CE、T2WI、T2FLAIR 和 DKI：评估：比较了胶质瘤患者病变侧和对侧的 PSMD 和 PSFW，以及患者和 HC 之间的 PSMD 和 PSFW。评估：比较了胶质瘤患者病变侧和对侧的 PSMD 和 PSFW，以及患者和 HC 之间的 PSMD 和 PSFW，并评估了这些指标与临床变量（包括 IDH1 突变）之间的关联。用 AWF 量化的胼胝体（CC）损伤被评估为 IDH1 突变对对侧 PSMD 和 PSFW 的介导效应：统计检验：配对 t 检验、方差分析、单变量和多变量线性回归、中介分析，显著性以 P 为标准：左侧胶质瘤的对侧 PSMD 和 PSFW 明显更高（PSMD: 0.206 ± 0.027 vs. 0.193 ± 0.023; PSFW：0.106±0.020），右侧胶质瘤的增幅相似（PSMD: 0.219 ± 0.036 vs. 0.195 ± 0.023; PSFW：0.129 ± 0.031 vs. 0.109 ± 0.020）。IDH1野生型胶质瘤与较高的对侧PSMD和PSFW相关（β = -0.302和-0.412）。CC的AWF介导了IDH1突变对对侧PSMD和PSFW的影响（介导比例：42.7%和53.7%）：数据结论：PSMD和PSFW是评估胶质瘤WM完整性的有效生物标志物，与IDH1突变状态显著相关。CC的AWF介导了IDH1突变与对侧PSMD和PSFW之间的关系。
Assessment the Impact of IDH Mutation Status on MRI Assessments of White Matter Integrity in Glioma Patients: Insights From Peak Width of Skeletonized Mean Diffusivity and Free Water Metrics.
Background: Gliomas are highly invasive brain tumors that evade accurate geographic assessment by conventional MRI due to microscopic invasion along white matter (WM) tracts. Advanced diffusion MRI techniques are needed to assess occult WM involvement.
Purpose: To evaluate peak width of skeletonized mean diffusivity (PSMD) and peak width of skeletonized free water (PSFW), and axonal water fraction (AWF) for assessing glioma-induced alterations in normal-appearing WM and their relationship with isocitrate dehydrogenase 1 (IDH1) mutation.
Study type: Retrospective.
Population: One hundred five glioma patients (46 ± 13 years), 53 healthy controls (HCs) (46 ± 9 years).
Field strength/sequence: 3.0 T, T1WI, T1-CE, T2WI, T2FLAIR, and DKI.
Assessment: PSMD and PSFW were compared between lesion and contralateral sides in glioma patients and between patients and HCs. The associations between these metrics and clinical variables, including IDH1 mutation, was assessed. Corpus callosum (CC) injury, quantified by the AWF, was evaluated for its mediated effect of IDH1 mutation on contralesional PSMD and PSFW.
Statistical tests: Paired-t tests, ANCOVA, univariate and multivariate linear regression, and mediation analysis with significance set at P < 0.05.
Results: Contralateral PSMD and PSFW were significantly higher in left-sided gliomas (PSMD: 0.206 ± 0.027 vs. 0.193 ± 0.023; PSFW: 0.119 ± 0.019 vs. 0.106 ± 0.020) than in HCs, with similar increases in right-sided gliomas (PSMD: 0.219 ± 0.036 vs. 0.195 ± 0.023; PSFW: 0.129 ± 0.031 vs. 0.109 ± 0.020). IDH1 wild-type gliomas were associated with higher contralateral PSMD and PSFW (β = -0.302 and -0.412). AWF of CC mediated the impact of IDH1 mutations on contralesional PSMD and PSFW (mediated proportion: 42.7% and 53.7%).
Data conclusion: PSMD and PSFW are effective biomarkers for assessing WM integrity in gliomas, significantly associated with IDH1 mutation status. AWF of CC mediates the relationship between IDH1 mutation and contralesional PSMD and PSFW.
期刊介绍：
The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.
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