Noninvasively evaluating the grading and IDH1 mutation status of diffuse gliomas by three-dimensional pseudo-continuous arterial spin labeling and diffusion-weighted imaging.

PURPOSE: To noninvasively evaluate the value of three-dimensional pseudo-continuous arterial spin labeling (3D pCASL) and diffusion-weighted imaging (DWI) in diffuse gliomas grading as well as isocitrate dehydrogenase (IDH) 1 mutation status.

METHODS: Fifty-six patients with pathologically confirmed diffuse gliomas with preoperative 3D pCASL and DWI were enrolled in this study. The Student's t test and Mann-Whitney U test were used to evaluate differences in parameters of DWI and 3D pCASL between low and high grade as well as between mutant and wild-type IDH1 diffuse gliomas; receiver operator characteristic (ROC) analysis was used to assess the diagnostic performance. Subsequently, a multivariate stepwise logistic regression analysis was used to identify the independent parameters. Besides, Kruskal-Wallis H test was used to examine the differences among grades II, III, and IV diffuse gliomas.

RESULTS: All parameters but CBFmean showed significant differences between low- and high-grade diffuse gliomas. In ROC analysis, the AUC of CBFmax , rCBFmean , rCBFmax , ADCmean , and ADCmin were 0.701, 0.730, 0.746, 0.810, and 0.856 respectively. Only the value of ADCmin was identified as the independent parameter in the differentiation of low- from high-grade diffuse gliomas. All parameters but CBFmean showed significant differences among the three grades. And the values of CBFmean , CBFmax , rCBFmean , and ADCmean showed significant differences between mutant and wild-type IDH1 in grade II-III astrocytoma.

CONCLUSION: Both 3D pCASL and DWI could be useful tools for distinguishing low- from high-grade diffuse gliomas and have the potential to differentiate different IDH1 mutation statuses of astrocytoma.