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Imaging prediction of isocitrate dehydrogenase (IDH) mutation in patients with glioma: a systemic review and meta-analysis

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Abstract

Objectives

To evaluate the imaging features of isocitrate dehydrogenase (IDH) mutant glioma and to assess the diagnostic performance of magnetic resonance imaging (MRI) for prediction of IDH mutation in patients with glioma.

Methods

A systematic search of Ovid-MEDLINE and EMBASE up to 10 October 2017 was conducted to find relevant studies. The search terms combined synonyms for ‘glioma’, ‘IDH mutation’ and ‘MRI’. Studies evaluating the imaging features of IDH mutant glioma and the diagnostic performance of MRI for prediction of IDH mutation in patients with glioma were selected. The pooled summary estimates of sensitivity and specificity and their 95% confidence intervals (CIs) were calculated using a bivariate random-effects model. The results of multiple subgroup analyses are reported.

Results

Twenty-eight original articles in a total of 2,146 patients with glioma were included. IDH mutant glioma showed frontal lobe predominance, less contrast enhancement, well-defined border, high apparent diffusion coefficient (ADC) value and low relative cerebral blood volume (rCBV) value. For the meta-analysis that included 18 original articles, the summary sensitivity was 86% (95% CI, 79%–91%) and the summary specificity was 87% (95% CI, 78–92%). In a subgroup analysis, the summary sensitivity of 2-hydroxyglutarate magnetic resonance spectroscopy (MRS) [96% (95% CI, 91–100%)] was higher than the summary sensitivities of other imaging modalities.

Conclusions

IDH mutant glioma consistently demonstrated less aggressive imaging features than IDH wild-type glioma. Despite the variety of different MRI techniques used, MRI showed the potential to non-invasively predict IDH mutation in patients with glioma. 2-Hydroxyglutarate MRS shows higher pooled sensitivity than other imaging modalities.

Key Points

• IDH mutant glioma showed frontal lobe predominance, less contrast enhancement, well-defined border, high ADC value, and low rCBV value.

• The diagnostic performance of MRI for prediction of IDH mutation in patients with glioma is within a clinically acceptable range, the summary sensitivity was 86% (95% CI, 79–91%) and the summary specificity was 87% (95% CI, 78–92%).

• In a subgroup analysis, the summary sensitivity of 2-hydroxyglutarate MRS [96% (95% CI, 91–100%)] was higher than the summary sensitivities of other imaging modalities.

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Abbreviations

ADC:

Apparent diffusion coefficient

APTw:

Amide proton transfer-weighted

DWI:

Diffusion-weighted imaging

HSROC:

Hierarchical summary receiver operating characteristic

IDH:

Isocitrate dehydrogenase

MRI:

Magnetic resonance imaging

MRS:

Magnetic resonance spectroscopy

PRISMA:

Preferred reporting items for systematic reviews and meta-analyses

PWI:

Perfusion-weighted imaging

QUADAS-2:

Quality assessment of diagnostic accuracy studies-2

rCBV:

Relative cerebral blood volume

WHO:

World Health Organization

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Funding

This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health and Welfare, Republic of Korea (1720030).

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-736, Republic of Korea

    Chong Hyun Suh, Ho Sung Kim, Seung Chai Jung, Choong Gon Choi & Sang Joon Kim

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  1. Chong Hyun Suh
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Correspondence to Ho Sung Kim.

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Guarantor

The scientific guarantor of this publication is Ho Sung Kim.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors (Chong Hyun Suh) has significant statistical expertise (4 years of experience in a systematic review and meta-analysis).

Ethical approval

Institutional Review Board approval was not required because of the nature of our study, which was a systemic review and meta-analysis.

Informed consent

Written informed consent was not required for this study because of the nature of our study, which was a systemic review and meta-analysis.

Methodology

• A systemic review and meta-analysis performed at one institution.

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Suh, C.H., Kim, H.S., Jung, S.C. et al. Imaging prediction of isocitrate dehydrogenase (IDH) mutation in patients with glioma: a systemic review and meta-analysis. Eur Radiol 29, 745–758 (2019). https://doi.org/10.1007/s00330-018-5608-7

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