Qualitative and Quantitative Magnetic Resonance Imaging Phenotypes May Predict CDKN2A/B Homozygous Deletion Status in Isocitrate Dehydrogenase-Mutant Astrocytomas: A Multicenter Study

• Published in: Korean journal of radiology 2023-02, Vol.24 (2), p.133-144
• Main Authors: Park, Yae Won, Park, Ki Sung, Park, Ji Eun, Ahn, Sung Soo, Park, Inho, Kim, Ho Sung, Chang, Jong Hee, Lee, Seung-Koo, Kim, Se Hoon
• Format: Article
• Language: English
• Subjects: Astrocytoma - diagnostic imaging; Astrocytoma - genetics; Astrocytoma - pathology; Brain cancer; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - genetics; Brain Neoplasms - pathology; Cell cycle; Cell division; Cyclin-Dependent Kinase Inhibitor p16 - genetics; Cyclin-dependent kinases; Dehydrogenases; Diffusion Magnetic Resonance Imaging; Female; Genomes; Homozygote; Humans; Isocitrate Dehydrogenase - genetics; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical prognosis; Mutation; Neuroimaging And Head & Neck; Patients; Peptides; Phenotype; Regression analysis; Sequence Deletion; Variables
• ISSN: 1229-6929; 2005-8330; 2005-8330
• DOI: 10.3348/kjr.2022.0732

Cyclin-dependent kinase inhibitor (CDKN)2A/B homozygous deletion is a key molecular marker of isocitrate dehydrogenase (IDH)-mutant astrocytomas in the 2021 World Health Organization. We aimed to investigate whether qualitative and quantitative MRI parameters can predict CDKN2A/B homozygous deletion status in IDH-mutant astrocytomas. Preoperative MRI data of 88 patients (mean age ± standard deviation, 42.0 ± 11.9 years; 40 females and 48 males) with IDH-mutant astrocytomas (76 without and 12 with CDKN2A/B homozygous deletion) from two institutions were included. A qualitative imaging assessment was performed. Mean apparent diffusion coefficient (ADC), 5th percentile of ADC, mean normalized cerebral blood volume (nCBV), and 95th percentile of nCBV were assessed via automatic tumor segmentation. Logistic regression was performed to determine the factors associated with CDKN2A/B homozygous deletion in all 88 patients and a subgroup of 47 patients with histological grades 3 and 4. The discrimination performance of the logistic regression models was evaluated using the area under the receiver operating characteristic curve (AUC). In multivariable analysis of all patients, infiltrative pattern (odds ratio [OR] = 4.25, = 0.034), maximal diameter (OR = 1.07, = 0.013), and 95th percentile of nCBV (OR = 1.34, = 0.049) were independent predictors of CDKN2A/B homozygous deletion. The AUC, accuracy, sensitivity, and specificity of the corresponding model were 0.83 (95% confidence interval [CI], 0.72-0.91), 90.4%, 83.3%, and 75.0%, respectively. On multivariable analysis of the subgroup with histological grades 3 and 4, infiltrative pattern (OR = 10.39, = 0.012) and 95th percentile of nCBV (OR = 1.24, = 0.047) were independent predictors of CDKN2A/B homozygous deletion, with an AUC accuracy, sensitivity, and specificity of the corresponding model of 0.76 (95% CI, 0.60-0.88), 87.8%, 80.0%, and 58.1%, respectively. The presence of an infiltrative pattern, larger maximal diameter, and higher 95th percentile of the nCBV may be useful MRI biomarkers for CDKN2A/B homozygous deletion in IDH-mutant astrocytomas.