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The cortical high-flow sign of oligodendroglioma, IDH-mutant and 1p/19q-codeleted: comparison between arterial spin labeling and dynamic susceptibility contrast methods

  • Diagnostic Neuroradiology
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Abstract

Purpose

The cortical high-flow sign with the non-enhancing area was reportedly found to be more frequent with oligodendroglioma, IDH-mutant and 1p/19q codeleted (ODG IDHm-codel) than with IDH-wildtype or astrocytoma, IDH-mutant on arterial spin labeling (ASL) in diffuse gliomas. This study aimed to compare the identification rate of the cortical high-flow sign on ASL in patients with ODG IDHm-codel to that on dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI).

Methods

Participants consisted of 32 adult ODG IDHm-codel patients with pathologically confirmed. Subtraction images were generated from paired control and label images on ASL. For DSC, dynamic T2*-weighted perfusion weighted images were obtained after pre-bolus of gadolinium-based contrast agent. Regional cerebral blood flow/volume maps were generated based on the concentration–time curve and arterial input function. Tumor-affecting cortices without contrast enhancement on conventional MR imaging were targeted. The identification rate of the cortical high-flow sign was compared between ASL and DSC using the Pearson’s Chi-Square test.

Results

Frequency of the cortical high-flow sign was significantly higher on ASL (18/32, 56.3%; p < 0.001) than on DSC (5/32, 15.6%). All cases with the positive cortical high-flow sign on DSC were identified on ASL.

Conclusion

ASL effectively identifies the cortical high-flow sign in ODG IDHm-codel, surpassing DSC in identification rates.

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Abbreviations

ASL:

Arterial spin labeling

DSC:

Dynamic susceptibility contrast-enhanced

IDH :

isocitrate dehydrogenase

ODG IDHm-codel :

Oligodendroglioma, IDH-mutant and 1p/19q-codeleted

PCR:

Polymerase chain reaction

PWI:

Perfusion-weighted imaging

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Funding

This work was supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI Grant number 22K07657.

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Authors and Affiliations

  1. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan

    Koji Yamashita & Kousei Ishigami

  2. Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan

    Osamu Togao & Kazufumi Kikuchi

  3. Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan

    Daisuke Kuga, Yuhei Sangatsuda, Yutaka Fujioka & Koji Yoshimoto

Authors
  1. Koji Yamashita
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  2. Osamu Togao
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  3. Kazufumi Kikuchi
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Corresponding author

Correspondence to Koji Yamashita.

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Conflict of interest

K Yamashita, OT, KK, DK, YS, YF, K Yoshimoto, and KI: Nothing to disclose.

Ethical approval

This study was approved by the institutional review board of our hospital (Kyushu University Institutional Review Board for Clinical Research).

Informed consent

Informed consent was waived because this study was retrospective nature.

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Yamashita, K., Togao, O., Kikuchi, K. et al. The cortical high-flow sign of oligodendroglioma, IDH-mutant and 1p/19q-codeleted: comparison between arterial spin labeling and dynamic susceptibility contrast methods. Neuroradiology 66, 187–192 (2024). https://doi.org/10.1007/s00234-023-03267-x

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  • DOI: https://doi.org/10.1007/s00234-023-03267-x

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