Share:
Share this content in WeChat
X
Review
Research progress of T2-FLAIR mismatch sign in predicting molecular typing of lower-grade glioma
WANG Hanwei  ZENG Linlan  CHEN Lizhao  WANG Shunan 

Cite this article as: Wang HW, Zeng LL, Chen LZ, et al. Research progress of T2-FLAIR mismatch sign in predicting molecular typing of lower-grade glioma[J]. Chin J Magn Reson Imaging, 2022, 13(9): 136-138, 143. DOI:10.12015/issn.1674-8034.2022.09.032.


[Abstract] T2-fluid attenuated inversion recovery (FLAIR) mismatch sign is an easily recognized imaging sign in conventional magnetic resonance imaging, which is characterized by homogenous hyperintensity of the glioma on T2WI and can be suppressed by FLAIR. A large number of studies have shown that this sign can effectively predict the molecular typing of lower–grade gliomas, especially for the prediction of isocitrate dehydrogenase (IDH) mutation and 1p/19q non-codeletion. T2-FLAIR mismatch sign has great potential in future clinical application due to its noninvasive and high specificity. In this paper, we review the definition of T2-FLAIR mismatch sign, pathological-image mechanism, and clinical application.
[Keywords] magnetic resonance imaging;T2-FLAIR mismatch sign;lower-grade gliomas;molecular typing

WANG Hanwei1, 2   ZENG Linlan1, 2   CHEN Lizhao3   WANG Shunan1, 2*  

1 Department of Radiology, Daping Hospital, Army Medical University, Chongqing 400042, China

2 Chongqing Clinical Research Centre of Imaging and Nuclear Medicine, Chongqing 400042, China

3 Department of Neurosurgery, Daping Hospital, Army Medical University, Chongqing 400042, China

*Wang SN, E-mail: wangshunan@tmmu.edu.cn

Conflicts of interest   None.

Received  2021-12-26
Accepted  2022-09-06
DOI: 10.12015/issn.1674-8034.2022.09.032
Cite this article as: Wang HW, Zeng LL, Chen LZ, et al. Research progress of T2-FLAIR mismatch sign in predicting molecular typing of lower-grade glioma[J]. Chin J Magn Reson Imaging, 2022, 13(9): 136-138, 143.DOI:10.12015/issn.1674-8034.2022.09.032

[1]
Louis DN, Perry A, Wesseling P, et al. The 2021 WHO Classification of Tumors of the Central Nervous System: a summary[J]. Neuro Oncol, 2021, 23(8): 1231-1251. DOI: 10.1093/neuonc/noab106.
[2]
Brat DJ, Verhaak RG, Aldape KD, et al. Comprehensive, Integrative Genomic Analysis of Diffuse lower-grade Gliomas[J]. N Engl J Med, 2015, 372(26): 2481-2498. DOI: 10.1056/NEJMoa1402121.
[3]
Olar A, Wani KM, Alfaro-Munoz KD, et al. IDH mutation status and role of WHO grade and mitotic index in overall survival in grade Ⅱ-Ⅲ diffuse gliomas[J]. Acta Neuropathol, 2015, 129(4): 585-596. DOI: 10.1007/s00401-015-1398-z.
[4]
Reuss DE, Mamatjan Y, Schrimpf D, et al. IDH mutant diffuse and anaplastic astrocytomas have similar age at presentation and little difference in survival: a grading problem for WHO[J]. Acta Neuropathol, 2015, 129(6): 867-873. DOI: 10.1007/s00401-015-1438-8.
[5]
Patel SH, Poisson LM, Brat DJ, et al. T2-FLAIR Mismatch, an Imaging Biomarker for IDH and 1p/19q Status in lower-grade Gliomas: A TCGA/TCIA Project[J]. Clin Cancer Res, 2017, 23(20): 6078-6085. DOI: 10.1158/1078-0432.Ccr-17-0560.
[6]
Lasocki A, Gaillard F, Gorelik A, et al. MRI Features Can Predict 1p/19q Status in Intracranial Gliomas[J]. AJNR Am J Neuroradiol, 2018, 39(4): 687-692. DOI: 10.3174/ajnr.A5572.
[7]
Broen MPG, Smits M, Wijnenga MMJ, et al. The T2-FLAIR mismatch sign as an imaging marker for non-enhancing IDH-mutant, 1p/19q-intact lower-grade glioma: a validation study[J]. Neuro Oncol, 2018, 20(10): 1393-1399. DOI: 10.1093/neuonc/noy048.
[8]
Batchala PP, Muttikkal TJE, Donahue JH, et al. Neuroimaging-Based Classification Algorithm for Predicting 1p/19q-Codeletion Status in IDH-Mutant Lower Grade Gliomas[J]. AJNR Am J Neuroradiol, 2019, 40(3): 426-432. DOI: 10.3174/ajnr.A5957.
[9]
Throckmorton P, Graber JJ. T2-FLAIR mismatch in isocitrate dehydrogenase mutant astrocytomas: Variability and evolution[J/OL]. Neurology, 2020, 95(11) [2022-08-29]. https://n.neurology.org/content/95/11/e1582. DOI: 10.1212/wnl.0000000000010324.
[10]
Johnson DR, Kaufmann TJ, Patel SH, et al. There is an exception to every rule-T2-FLAIR mismatch sign in gliomas[J]. Neuroradiology, 2019, 61(2): 225-227. DOI: 10.1007/s00234-018-2148-4.
[11]
Juratli TA, Tummala SS, Riedl A, et al. Radiographic assessment of contrast enhancement and T2/FLAIR mismatch sign in lower grade gliomas: correlation with molecular groups[J]. J Neurooncol, 2019, 141(2): 327-335. DOI: 10.1007/s11060-018-03034-6.
[12]
Corell A, Ferreyra Vega S, Hoefling N, et al. The clinical significance of the T2-FLAIR mismatch sign in grade Ⅱ and Ⅲ gliomas: a population-based study[J/OL]. BMC Cancer, 2020, 20(1) [2022-08-29]. https://bmccancer.biomedcentral.com/track/pdf/10.1186/s12885-020-06951-w.pdf. DOI: 10.1186/s12885-020-06951-w.
[13]
Aliotta E, Dutta SW, Feng X, et al. Automated apparent diffusion coefficient analysis for genotype prediction in lower grade glioma: association with the T2-FLAIR mismatch sign[J]. J Neurooncol, 2020, 149(2): 325-335. DOI: 10.1007/s11060-020-03611-8.
[14]
Lee MK, Park JE, Jo Y, et al. Advanced imaging parameters improve the prediction of diffuse lower-grade gliomas subtype, IDH mutant with no 1p19q codeletion: added value to the T2/FLAIR mismatch sign[J]. Eur Radiol, 2020, 30(2): 844-854. DOI: 10.1007/s00330-019-06395-2.
[15]
Yang X, Lin Y, Xing Z, et al. Predicting 1p/19q codeletion status using diffusion-, susceptibility-, perfusion-weighted, and conventional MRI in IDH-mutant lower-grade gliomas[J]. Acta Radiol, 2021, 62(12): 1657-1665. DOI: 10.1177/0284185120973624.
[16]
Tay KL, Tsui A, Phal PM, et al. MR imaging characteristics of protoplasmic astrocytomas[J]. Neuroradiology, 2011, 53(6): 405-411. DOI: 10.1007/s00234-010-0741-2.
[17]
Louis DN, Ohgaki H, Wiestler OD, et al. The 2007 WHO classification of tumours of the central nervous system[J]. Acta Neuropathol, 2007, 114(2): 97-109. DOI: 10.1007/s00401-007-0243-4.
[18]
Deguchi S, Oishi T, Mitsuya K, et al. Clinicopathological analysis of T2-FLAIR mismatch sign in lower-grade gliomas[J/OL]. Sci Rep, 2020, 10(1) [2022-08-29]. https://www.nature.com/articles/s41598-020-67244-7.pdf. DOI: 10.1038/s41598-020-67244-7.
[19]
Fujita Y, Nagashima H, Tanaka K, et al. The Histopathologic and Radiologic Features of T2-FLAIR Mismatch Sign in IDH-Mutant 1p/19q Non-codeleted Astrocytomas[J/OL]. World Neurosurg, 2021, 149 [2022-08-29]. https://www.sciencedirect.com/science/article/pii/S1878875021002345?via%3Dihub. DOI: 10.1016/j.wneu.2021.02.042.
[20]
Yamashita S, Takeshima H, Kadota Y, et al. T2-fluid-attenuated inversion recovery mismatch sign in lower grade gliomas: correlation with pathological and molecular findings[J]. Brain Tumor Pathol, 2022, 39(2): 88-98. DOI: 10.1007/s10014-022-00433-6.
[21]
Zhao K, Sun G, Wang Q, et al. The Diagnostic Value of Conventional MRI and CT Features in the Identification of the IDH1-Mutant and 1p/19q Co-Deletion in WHO GradeⅡGliomas[J/OL]. Acad Radiol, 2021, 28(7) [2022-08-29]. https://www.sciencedirect.com/science/article/abs/pii/S1076633220301495?via%3Dihub. DOI: 10.1016/j.acra.2020.03.008.
[22]
Radović N, Špero M, Hrkać Pustahija A, et al. T2-Fluid-Attenuated Inversion Recovery Mismatch Sign in Grade Ⅱ and Ⅲ Gliomas: Is There a Coexisting T2-Diffusion-Weighted Imaging Mismatch?[J]. J Comput Assist Tomogr, 2022, 46(2): 251-256. DOI: 10.1097/rct.0000000000001267.
[23]
Foltyn M, Nieto Taborda KN, Neuberger U, et al. T2/FLAIR-mismatch sign for noninvasive detection of IDH-mutant 1p/19q non-codeleted gliomas: validity and pathophysiology[J/OL]. Neurooncol Adv, 2020, 2(1) [2022-08-29]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7212872/pdf/vdaa004.pdf. DOI: 10.1093/noajnl/vdaa004.
[24]
Kinoshita M, Uchikoshi M, Sakai M, et al. T(2)-FLAIR Mismatch Sign Is Caused by Long T(1) and T(2) of IDH-mutant, 1p19q Non-codeleted Astrocytoma[J]. Magn Reson Med Sci, 2021, 20(1): 119-123. DOI: 10.2463/mrms.bc.2019-0196.
[25]
Yeniçeri İ, Yıldız ME, Özduman K, et al. The reliability and interobserver reproducibility of T2/FLAIR mismatch in the diagnosis of IDH-mutant astrocytomas[J]. Diagn Interv Radiol, 2021, 27(6): 796-801. DOI: 10.5152/dir.2021.20624.
[26]
Pinto C, Noronha C, Taipa R, et al. T2–FLAIR mismatch sign: a roadmap of pearls and pitfalls[J/OL]. Br J Radiol, 2022, 95(1129) [2022-08-29]. https://www.birpublications.org/DOI/epub/10.1259/bjr.20210825. DOI: 10.1259/bjr.20210825.
[27]
Gupta M, Gupta A, Yadav V, et al. Comparative evaluation of intracranial oligodendroglioma and astrocytoma of similar grades using conventional and T1-weighted DCE-MRI[J]. Neuroradiology, 2021, 63(8): 1227-1239. DOI: 10.1007/s00234-021-02636-8.
[28]
Lasocki A, Buckland ME, Drummond KJ, et al. Conventional MRI features can predict the molecular subtype of adult grade 2-3 intracranial diffuse gliomas[J/OL]. Neuroradiology, 2022 [2022-08-29]. https://link.springer.com/content/pdf/10.1007/s00234-022-02975-0.pdf. DOI: 10.1007/s00234-022-02975-0.
[29]
Onishi S, Amatya VJ, Kolakshyapati M, et al. T2-FLAIR mismatch sign in dysembryoplasticneuroepithelial tumor[J/OL]. Eur J Radiol, 2020, 126 [2022-08-29]. https://www.sciencedirect.com/science/article/pii/S0720048X20301133?via%3Dihub. DOI: 10.1016/j.ejrad.2020.108924.
[30]
Yamasaki F, Nishibuchi I, Karakawa S, et al. T2-FLAIR Mismatch Sign and Response to Radiotherapy in Diffuse Intrinsic Pontine Glioma[J]. Pediatr Neurosurg, 2021, 56(1): 1-9. DOI: 10.1159/000513360.
[31]
Lasocki A, Anjari M, Rs Kokurcan S, et al. Conventional MRI features of adult diffuse glioma molecular subtypes: a systematic review[J]. Neuroradiology, 2021, 63(3): 353-362. DOI: 10.1007/s00234-020-02532-7.
[32]
Xing Z, Zhang H, She D, et al. IDH genotypes differentiation in glioblastomas using DWI and DSC-PWI in the enhancing and peri-enhancing region[J]. Acta Radiol, 2019, 60(12): 1663-1672. DOI: 10.1177/0284185119842288.
[33]
Zhang HW, Lyu GW, He WJ, et al. DSC and DCE Histogram Analyses of Glioma Biomarkers, Including IDH, MGMT, and TERT, on Differentiation and Survival[J/OL]. Acad Radiol, 2020, 27(12) [2022-08-29]. https://www.sciencedirect.com/science/article/abs/pii/S1076633219306245?via%3Dihub. DOI: 10.1016/j.acra.2019.12.010.
[34]
Yoo RE, Yun TJ, Hwang I, et al. Arterial spin labeling perfusion-weighted imaging aids in prediction of molecular biomarkers and survival in glioblastomas[J]. Eur Radiol, 2020, 30(2): 1202-1211. DOI: 10.1007/s00330-019-06379-2.
[35]
De La Fuente MI, Young RJ, Rubel J, et al. Integration of 2-hydroxyglutarate-proton magnetic resonance spectroscopy into clinical practice for disease monitoring in isocitrate dehydrogenase-mutant glioma[J]. Neuro Oncol, 2016, 18(2): 283-290. DOI: 10.1093/neuonc/nov307.
[36]
Ozturk-Isik E, Cengiz S, Ozcan A, et al. Identification of IDH and TERTp mutation status using (1) H-MRS in 112 hemispheric diffuse gliomas[J]. J Magn Reson Imaging, 2020, 51(6): 1799-1809. DOI: 10.1002/jmri.26964.
[37]
Song S, Wang L, Yang H, et al. Static (18)F-FET PET and DSC-PWI based on hybrid PET/MR for the prediction of gliomas defined by IDH and 1p/19q status[J]. Eur Radiol, 2021, 31(6): 4087-4096. DOI: 10.1007/s00330-020-07470-9.
[38]
Xing Z, Yang X, She D, et al. Noninvasive Assessment of IDH Mutational Status in World Health Organization Grade Ⅱ and Ⅲ Astrocytomas Using DWI and DSC-PWI Combined with Conventional MR Imaging[J]. AJNR Am J Neuroradiol, 2017, 38(6): 1138-1144. DOI: 10.3174/ajnr.A5171.
[39]
Kim M, Jung SY, Park JE, et al. Diffusion- and perfusion-weighted MRI radiomics model may predict isocitrate dehydrogenase (IDH) mutation and tumor aggressiveness in diffuse lower grade glioma[J]. Eur Radiol, 2020, 30(4): 2142-2151. DOI: 10.1007/s00330-019-06548-3.
[40]
Sun C, Fan L, Wang W, et al. Radiomics and Qualitative Features From Multiparametric MRI Predict Molecular Subtypes in Patients With lower-grade Glioma[J/OL]. Front Oncol, 2021, 11 [2022-08-29]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8814098/pdf/fonc-11-756828.pdf. DOI: 10.3389/fonc.2021.756828.

PREV Application and research progress of MRI on cerebral small vessel disease and vascular cognitive impairment
NEXT Research progress in MRI of anti‐N‐methyl‐D‐aspartate receptor encephalitis
  



Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn