Article Figures & Data
Figures
- Fig 1.
A 38-year-old man with a left frontal lobe diffuse astrocytoma, IDH-mutant and 1p/19q-noncodeleted, showing characteristic imaging features. A, On T2WI, the mass is homogeneously hyperintense, sharply marginated, and without significant cortical infiltration. B, FLAIR sequence shows central suppression of signal compared with the T2WI, except for a peripheral rim (ie, T2-FLAIR mismatch sign). C, T2*WI shows lack of susceptibility blooming.
- Fig 2.
A 54-year-old woman with a left frontal lobe oligodendroglioma, IDH-mutant and 1p/19q-codeleted, showing characteristic imaging features. A and B, T2WI and FLAIR demonstrate a heterogeneous and poorly marginated mass with significant cortical infiltration and no T2-FLAIR mismatch sign. C, T2*WI shows regions of striking susceptibility blooming.
- Fig 3.
Classification algorithm for 1p/19q-codeletion status in IDH-mutant LGGs, derived from an analysis of the TCGA/TCIA training cohort. The first step of the algorithm is an assessment of the T2-FLAIR mismatch sign; when present, it indicates, with high certainty, the IDH-mutant 1p/19q-noncodeleted subtype. When the T2-FLAIR mismatch sign is absent (or unavailable), a multivariate logistic regression model based on tumor texture, patient age, T2* blooming, tumor location, and hydrocephalus is applied. The equation for the logistic regression model is the following: ρ codeleted = exp[(Xβ) / (1+exp(Xβ)′], where Xβ = −4.8834 + 2.7842 × (texture <75% homogeneous) + 0.0587 × (patient age) + 3.1948 × (T2* susceptibility blooming present) + 1.6646 × (primary lobe = frontal) − 3.4496 × (hydrocephalus = present). A predicted probability threshold of 0.40 was established for the logistic regression model, based on the Youden J statistic. Cases were classified as either 1p/19q codeleted or non-codeleted based on whether their predicted probability was ≥ or < 0.40, respectively.
Tables
- Table 1:
Univariate logistic regression analyses for predicting 1p/19q codeletion among the training dataset
Predictor Ratio Odds Ratio (95% CI) P Value Maximum diameter (cm) 1st Quartile: 3rd quartile 1.33 (0.70–2.49) .381 Margins Irregular: sharp 1.04 (0.47–2.33) .917 Texture Homogeneous (<75%): homogeneous (>75%) 12.33 (4.66–31.58) <.001a Peritumoral edema Yes: no 1.42 (0.62–3.23) .973 Hydrocephalus No: yes 2.32 (0.88–6.11) .089 Midline shift (cm)b 1st Quartile: 3rd quartile 4.27 (1.49–12.23) .027a Enhancement Yes: no 1.28 (0.57–2.86) .555 Necrosis Yes: no 2.18 (0.61–7.69) .228 T2* blooming Yes: no 6.92 (2.04–23.49) .002a Cortical infiltration Yes: no 2.02 (0.67–6.10) .212 Cyst No: yes 1.18 (0.48–2.91) .715 T2 FLAIR mismatch signc No: yes 22.50 (6.26–∞) <.001a Gliomatosis Yes: no 1.13 (0.18–7.08) .896 Primary lobe Frontal: nonfrontal 5.68 (2.08–15.44) .001a Age 3rd Quartile: 1st quartile 3.38 (1.71–6.71) <.001a Sex Female: male 1.55 (0.69–3.50) .283 - Table 3:
Validation dataset classification summary for predicting 1p/19q codeletion with 2 independent readers based on the classification algorithm in Fig 3a
Reader A Prediction Molecular Status Reader B Prediction Molecular Status 1p/19q Codeleted 1p/19q Noncodeleted 1p/19q Codeleted 1p/19q Noncodeleted 1p/19q Codeleted 48 12 1p/19q Codeleted 48 15 1p/19q Noncodeleted 8 38 1p/19q Noncodeleted 7 36 ↵a Overall prediction accuracy was 81.1% for reader A and 79.2% for reader B.
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