Correlation between Arterial Spin Labeling and Dynamic Susceptibility Contrast MRI to Determine IDH Mutation Status on Non-Enhancing Glioma

Abstract

Background: Glioma is a type of brain, originating from glial cells that support nerve cells, such as astrocytes and dendrocytes. It varies in type and severity, often resulting in a low life expectancy due to its aggressive nature. Since the implementation of the 2016 WHO Central Nervous System tumor classification, Isocitrate Dehydrogenase (IDH) mutation status has been used as a marker to distinguish the severity of the gliomas. This research explores the correlation between Arterial Spin Labeling (ASL) and Dynamic Susceptibility Contrast (DSC) MRI techniques to determine IDH mutation status in non-enhancing gliomas. Methods: This project used 34 iGene patient dataset. To overlay ASL to DSC, both images were registered to the FLAIR images as the registration reference. The statistical analysis was done by dividing the tumor region for both ASL and DSC into three areas: hypo-perfusion, iso-perfusion, and hyperperfusion. Then, the images were flattened from 3D to 1D data and the statistical analysis was done with Spearman’s correlation. The correlation between those three areas for two imaging techniques resulted in nine cases. To test the interclass significance, the Mann Whitney-U test was used. Results: This project found a higher mismatch area between ASL-CBF and DSC-rCBV in the IDHwildtype group compared to the IDH-mutant group. Additionally, the mismatch area in IDH-wildtype shows a lower Spearman’s coefficient, suggesting different information captured by those two imaging techniques. It reveals significant findings that both ASL-CBF and DSC-rCBV can be valuable in distinguishing IDH mutation statuses, with notable differences in perfusion characteristics between IDH-mutant and IDH-wildtype gliomas. Conclusion: Voxel-wise correlation between ASL-CBF and DSC-rCBV can be a potential marker to distinguish IDH-mutant from IDH-wildtype.