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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Neuro-Oncology and Neurosurgical Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1507335

Multipool-CEST and CEST-based pH assessment as predictive tools for glioma grading, IDH mutation, 1p/19q codeletion, and MGMT promoter methylation in gliomas

Provisionally accepted
Xinli Zhang Xinli Zhang 1Jue Lu Jue Lu 1Xiaoming Liu Xiaoming Liu 1Peng Sun Peng Sun 2Qian Qin Qian Qin 1Zhengdong Xiang Zhengdong Xiang 1Lan Cheng Lan Cheng 1Xiaoxiao Zhang Xiaoxiao Zhang 2Xiaotong Guo Xiaotong Guo 1Jing Wang Jing Wang 1*
  • 1 Department of Radiology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
  • 2 Philips (China), Beijing, Beijing Municipality, China

The final, formatted version of the article will be published soon.

    Objectives: To comprehensively and noninvasively predict glioma grade, IDH mutation status, 1p/19q codeletion status, and MGMT promoter methylation status using chemical exchange saturation transfer (CEST)-based tumor pH assessment and metabolic profiling.We analyzed 128 patients with pathologically confirmed adult diffuse glioma. CEST-derived metrics based on tumor regions were obtained using five-pool Lorentzian analysis and pH_weighted analysis. Histogram features of these metrics were computed to characterize tumor heterogeneity. These features were subsequently employed for glioma grading and molecular genotyping of IDH, 1p/19q and MGMT. Logistic regression analysis was used to predict the grade and IDH genotypes. The diagnostic performance was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC) analysis.The DS, MT and pH_weighted differed significantly between grade II and III, as well as grade III and IV.The amide, NOE, pH_weighted and MTR3.5 showed significantly differences within IDH genotypes. Regression models achieved the highest AUC for differentiating grade II from III (0.80, 95% CI: 0.64-0.91), grade III from IV (0.83, 95% CI: 0.74-0.90), and IDH mutant from wild status (0.84, 95% CI: 0.77-0.90). MT and pH_weighted metrics were the only indicators for identifying 1p/19q codeletion in grade II and grade III gliomas, respectively. MT 90th percentile (0.87, 95% CI: 0.65-0.98) and pH_weighted 25th percentile (0.83, 95% CI: 0.56-0.97) showed the best performance, respectively. The MTR3.5 was the only indicator which can distinguish MGMT promoter methylation and unmethylation gliomas, within MTR3.5 90th percentile performed best (AUC = 0.79, 95% CI: 0.61-0.91).CEST-based tumor pH assessment and metabolic profiling demonstrated promising potential for predicting glioma grade, IDH mutation status, 1p/19q codeletion, and MGMT genotype.

    Keywords: Glioma, IDH, 1p/19q codeletion, MGMT, pH assessment

    Received: 07 Oct 2024; Accepted: 04 Dec 2024.

    Copyright: © 2024 Zhang, Lu, Liu, Sun, Qin, Xiang, Cheng, Zhang, Guo and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jing Wang, Department of Radiology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.