• Sabahattin Yuzkan, Samet Mutlu, Mehmet Han, AkkurtTuce SoylemezTSDepartment of Pathology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey., Fahir Sencan, Fatmagul Kusku Cabuk, Omur Gunaldi, Bekir Tugcu, and Burak Kocak.
• Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey. Electronic address: sabahyuzkan@gmail.com.
• World Neurosurg. 2023 Jun 28.

ObjectiveTo determine whether diffusion tensor imaging (DTI) parameters acquired with model-based DTI and model-free generalized Q-sampling imaging (GQI) reconstructions may noninvasively predict isocitrate dehydrogenase (IDH) mutational status in patients with grade 2-4 gliomas.MethodsForty patients with known IDH genotype (28 IDH wild-type; 12 IDH mutant) who underwent preoperative DTI evaluation on a 3-Tesla magnetic resonance imaging scanner were analyzed retrospectively. Absolute values obtained from model-based and model-free reconstructions were compared. Using the intraclass correlation coefficient, interobserver agreement was assessed for various sampling techniques. Variables having statistically significant distributions between IDH groups were subjected to a receiver operating characteristic (ROC) analysis. Using multivariable logistic regression analysis, independent predictors, if present, were identified and a model was developed.ResultsSix imaging parameters (3 from model-based DTI and 3 from model-free GQI reconstructions) showed statistically significant differences between groups (P < 0.001, power >0.97), with very high correlation to each other (P < 0.001). Age difference between the groups was statistically significant (P < 0.001). The optimal logistic regression model comprised a GQI-based parameter and age, which were independent predictors as well, producing an area under the ROC curve, accuracy, sensitivity, and specificity of 0.926, 85%, 75%, and 89.3%, respectively. Using the GQI reconstruction feature alone with a cut-off of 1.60, an 85% of accuracy was also achieved with ROC analysis.ConclusionsThe imaging parameters acquired from model-based DTI and model-free GQI reconstructions, combined with the clinical variable age, may have the ability to noninvasively predict the IDH genotype in gliomas, either alone or in particular combinations.Copyright © 2023 Elsevier Inc. All rights reserved.

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