Magnetic Resonance Imaging Applications in Lower-Grade Gliomas

Magnetic resonance imaging (MRI) is central to the diagnosis, treatment planning and longitudinal monitoring of lower-grade gliomas, defined as World Health Organization grade II and III infiltrative tumours. Conventional sequences such as T1-weighted, T2-weighted and fluid-attenuated inversion recovery (FLAIR) delineate lesion morphology, infiltration and associated oedema. Advanced techniques—including diffusion-weighted imaging to probe tissue microstructure, perfusion-weighted imaging to assess vascularity and relative cerebral blood volume, and proton magnetic resonance spectroscopy to characterise metabolic profiles—provide non-invasive insight into tumour biology. Recent progress in quantitative image analysis and radiomics, often coupled with machine learning, has enabled more accurate prediction of molecular markers such as isocitrate dehydrogenase (IDH) mutation and 1p/19q co-deletion, improving personalised management and prognostication for patients worldwide.

Research from Nature Portfolio

Foundational work has revealed that IDH mutation status in lower-grade gliomas is associated with a unique hypoxia and angiogenesis transcriptome signature that can be reliably inferred from relative cerebral blood volume (rCBV) measurements. In treatment-naive patients, a one-unit increase in rCBV corresponded to a substantial decrease in the likelihood of harbouring an IDH mutation, yielding high accuracy in non-invasive genotype prediction. This study demonstrated the promise of perfusion MRI as a surrogate marker for underlying genetic and microvascular alterations, paving the way for radiogenomic integration in clinical protocols.

Magnetic Resonance Imaging Applications in Lower-Grade Gliomas publication trend

The graph below shows the total number of articles in magnetic resonance imaging applications in lower-grade gliomas across all publications each year (not limited to Nature Index journals).

Technical terms

Lower-grade gliomas: Infiltrative brain tumours classified as WHO grade II or III.

Isocitrate dehydrogenase (IDH) mutation: A genetic alteration affecting metabolic enzyme function, prognostically favourable in gliomas.

1p/19q co-deletion: Concurrent loss of chromosomal arms 1p and 19q, defining oligodendroglioma subtype and associated with treatment response.

Radiomics: Extraction of high-dimensional quantitative features from medical images for predictive modelling.

T2-FLAIR mismatch sign: A radiological pattern in FLAIR images indicating non-enhancing lesion core with surrounding hyperintensity.

Apparent diffusion coefficient (ADC): Quantitative measure of water diffusivity in tissue, derived from diffusion-weighted imaging.

Fractional anisotropy (FA): Metric of directional water diffusion, reflecting tissue microstructure integrity in diffusion tensor imaging.

Relative cerebral blood volume (rCBV): Ratio of tumour perfusion to normal brain perfusion, indicative of neovascularisation.

References

1. Multi-Parametric Radiomic Model to Predict 1p/19q Co-Deletion in Patients with IDH-1 Mutant Glioma: Added Value to the T2-FLAIR Mismatch Sign. Cancers (2023).
2. Prediction of IDH1-Mutation and 1p/19q-Codeletion Status Using Preoperative MR Imaging Phenotypes in Lower Grade Gliomas. American Journal of Neuroradiology (2017).
3. IDH mutation status is associated with a distinct hypoxia/angiogenesis transcriptome signature which is non-invasively predictable with rCBV imaging in human glioma. Scientific Reports (2015).