Journal of Neuro-Oncology

, Volume 131, Issue 1, pp 93–101 | Cite as

In vivo molecular profiling of human glioma using diffusion kurtosis imaging

  • Johann-Martin HempelEmail author
  • Sotirios Bisdas
  • Jens Schittenhelm
  • Cornelia Brendle
  • Benjamin Bender
  • Henk Wassmann
  • Marco Skardelly
  • Ghazaleh Tabatabai
  • Salvador Castaneda Vega
  • Ulrike Ernemann
  • Uwe Klose
Clinical Study


The purpose of this study is to assess the diagnostic performance of diffusion kurtosis imaging (DKI) for in vivo molecular profiling of human glioma. Normalized mean kurtosis (MKn) and mean diffusivity (MDn) metrics from DKI were assessed in 50 patients with histopathologically confirmed glioma. The results were compared in regard to the WHO-based histological findings and molecular characteristics leading to integrated diagnosis (Haarlem Consensus): isocitrate-dehydrogenase (IDH1/2) mutation status, alpha-thalassemia/mental retardation syndrome X-linked (ATRX) expression, chromosome 1p/19q loss of heterozygosity (LOH), and O6-methylguanine DNA methyltransferase (MGMT) promoter methylation status. MKn was significantly lower in tumors with IDH1/2 mutation (0.43 ± 0.09) and ATRX loss of expression (0.41 ± 0.11) than in those with IDH1/2 wild type (0.57 ± 0.09, p < 0.001) and ATRX maintained expression (0.51 ± 0.10, p = 0.004), respectively. Regarding the integrated molecular diagnosis, MKn was significantly higher in primary glioblastoma (0.57 ± 0.10) than in astrocytoma (0.39 ± 0.11, p < 0.001) and oligodendroglioma (0.47 ± 0.05, p = 0.003). MK may be used to provide insight into the human glioma molecular profile regarding IDH1/2 mutation status and ATRX expression. Considering the diagnostic and prognostic significance of these molecular markers, MK appears to be a promising in vivo biomarker for glioma. The diagnostic performance of MK seems to fit more with the integrated molecular approach than the conventional histological findings of the current WHO 2007 classification.


Diffusion kurtosis imaging Glioma Isocitrate dehydrogenase IDH1/2 ATRX 1p/19q LOH MGMT Integrated diagnosis Haarlem consensus 



We thank Robert Grimm from Siemens (Erlangen, Germany) for support in image post-processing.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Johann-Martin Hempel
    • 1
    Email author
  • Sotirios Bisdas
    • 1
    • 2
  • Jens Schittenhelm
    • 3
  • Cornelia Brendle
    • 1
  • Benjamin Bender
    • 1
  • Henk Wassmann
    • 1
  • Marco Skardelly
    • 4
  • Ghazaleh Tabatabai
    • 5
  • Salvador Castaneda Vega
    • 6
  • Ulrike Ernemann
    • 1
  • Uwe Klose
    • 1
  1. 1.Department of NeuroradiologyEberhard Karls UniversityTübingenGermany
  2. 2.Department of Neuroradiology, National Hospital of Neurology and NeurosurgeryUniversity College London HospitalsLondonUK
  3. 3.Institute of NeuropathologyEberhard Karls UniversityTübingenGermany
  4. 4.Department of NeurosurgeryEberhard Karls UniversityTübingenGermany
  5. 5.Centre of Neurooncology, Comprehensive Cancer Center Tübingen-StuttgartEberhard Karls UniversityTübingenGermany
  6. 6.Department of Preclinical Imaging and Radiopharmacy, Werner Siemens Imaging CenterEberhard Karls UniversityTübingenGermany

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