MR textural analysis on T2 FLAIR images for the prediction of true oligodendroglioma by the 2016 WHO genetic classification

Background The genetic status of 1p/19q is important for differentiating oligodendroglioma, isocitrate‐dehydrogenase (IDH)‐mutant, and 1p/19q‐codeleted from diffuse astrocytoma, IDH‐mutant according to the 2016 World Health Organization (WHO) criteria. Purpose To assess the value of magnetic resonance textural analysis (MRTA) on T2 fluid‐attenuated inversion recovery (FLAIR) images for making a genetically integrated diagnosis of true oligodendroglioma by WHO guidelines. Study Type Retrospective case control. Subjects In all, there were 54 patients with a histopathological diagnosis of diffuse glioma (grade II). All were tested for IDH and 1p/19q. Field Strength/Sequence 3.0T, including T2 FLAIR sequence, axial T1‐weighted, and T2‐weighted sequence. Assessment MRTA on a representative tumor region of interest (ROI) was made on preoperative T2 FLAIR images around the area that had the largest diameter of solid tumor using Omni Kinetics software. Statistical Tests Differences between IDH‐mutant and 1p/19q‐codeleted and IDH‐mutant and 1p/19q‐intact gliomas were analyzed by the Mann–Whitney rank sum test. Receiver operating characteristic curves (ROC) were created to assess MRTA diagnostic performance. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated with a cutoff value according to the Youden Index. Results Comparisons demonstrated significant differences in kurtosis (P = 0.007), energy (0.008), entropy (0.008), mean deviation (MD) (0.7. MD had the highest diagnostic performance, with AUC = 0.878, sensitivity = 94.1%, specificity = 75.0%, PPV = 86.5%, and NPV = 88.2%. Data Conclusion MRTA on T2 FLAIR images may be helpful in identifying oligodendroglioma, IDH‐mutant, and 1p/19q‐codeleted. Level of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017.