Enhancing glioma care with advanced imaging: T2-FLAIR mismatch as a predictive biomarker in IDH-mutant astrocytoma

Neurosurg Rev. 2024 Aug 30;47(1):512. doi: 10.1007/s10143-024-02748-8.

Abstract

The study highlights that diffuse glioma, a prevalent type of brain tumor, affect approximately 100,000 individuals worldwide each year. IDH-mutant astrocytoma and oligodendrogliomas typically have a more favorable prognosis compared to IDH-wildtype glioblastomas. However, many IDH-mutant astrocytoma has the potential to progress to grade 4 glioblastomas, leading to a less favorable prognosis. In a recent investigation, Shumpei Onishi et al. examined the T2-FLAIR mismatch sign as a possible imaging biomarker for assessing CDKN2A status in non-enhancing IDH-mutant astrocytoma. The findings indicate that the T2-FLAIR mismatch sign is linked to CDKN2A-intact astrocytoma, providing a valuable tool for diagnostic and prognostic purposes. Additionally, the use of Indocyanine Green (ICG) for real-time visualization during neurosurgical procedures demonstrates potential, though it may have limitations in specificity. While these advancements offer promise in glioma management, there remains a critical need for larger, standardized studies to validate these findings and further improve treatment outcomes.

Keywords: CDKN2A deletion; Diffuse gliomas; IDH-mutant astrocytoma; Imaging biomarkers; Radiological features; Super T2-FLAIR mismatch sign; T2-FLAIR mismatch sign.

Publication types

  • Review
  • Letter

MeSH terms

  • Astrocytoma* / diagnostic imaging
  • Astrocytoma* / genetics
  • Biomarkers, Tumor / genetics
  • Brain Neoplasms* / diagnostic imaging
  • Brain Neoplasms* / genetics
  • Glioma* / diagnostic imaging
  • Glioma* / genetics
  • Humans
  • Isocitrate Dehydrogenase* / genetics
  • Magnetic Resonance Imaging / methods
  • Mutation*
  • Prognosis

Substances

  • Isocitrate Dehydrogenase
  • Biomarkers, Tumor