Purpose: H3 K27M-mutant diffuse midline gliomas are associated with worse prognosis than H3 K27M wild-type gliomas. In the present study, we sought to evaluate the conventional magnetic resonance imaging (cMRI) of H3 K27M-mutant glioma and examine whether diffusion-weighted imaging (DWI) derived apparent diffusion coefficient (ADC) could noninvasively predict H3 K27M mutational status in brain diffuse midline gliomas.
Materials and methods: The institutional review board approved this study and waived the requirement for informed consent. Thirty-eight patients with brain diffuse midline gliomas were retrospectively reviewed. The parameters of preoperative cMRI were evaluated. The minimal ADC, peritumoral ADC, ratio of minimal ADC, and ratio of peritumoral ADC were measured, and significant differences between the two groups were identified by logistic regression analysis adjusted for age and tumor location. Receiver operating characteristic curves and logistic regression analysis adjusted for age and tumor location were used to assess the diagnostic performances of the minimal ADC, peritumoral ADC, ratio of minimal ADC, and ratio of peritumoral ADC.
Results: H3 K27M-mutant gliomas in different locations have diverse imaging characteristics. Minimal ADC, peritumoral ADC, ratio of minimal ADC, and ratio of peritumoral ADC values were significantly lower in the H3 K27M-mutant gliomas than in the wild-type gliomas (P < 0.05). The combination of ratio of minimal ADC and ratio of peritumoral ADC provided the largest area under the curve (AUC) of 0.872 in defining H3 K27M-mutational status.
Conclusions: The combination of ratio of minimal ADC and ratio of peritumoral ADC can noninvasively detect the H3 K27M mutational status in brain diffuse midline gliomas.
Keywords: Conventional MRI; Diffusion-weighted imaging; H3 K27M-mutant.
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