Diagnostic accuracy of the t2/flair mismatch sign in predicting isocitrate dehydrogenase mutation in low-grade gliomas

Document Type

Article

Department

Pathology and Laboratory Medicine

Abstract

BACKGROUND: Gliomas represent a significant global health burden due to their high morbidity, infiltrative nature and often limited therapeutic options. MRI is pivotal in their diagnosis, providing detailed structural and functional assessments that refines tumor characterization. Accurate MRI driven evaluation carries strong prognostic implications, guiding personalized treatment and improving outcome prediction
OBJECTIVES: To evaluate diagnostic accuracy of T2/FLAIR mismatch sign in predicting IDH mutations in low grade gliomas.
METHODOLOGY: This cross-sectional study analyzed 52 histologically confirmed glioma patients from 2022 to 2024 at AKUH. Preoperative 1.5T (GE) and 3T (Toshiba) MRI were reviewed by two neuroradiologists for T2/FLAIR mismatch and additional imaging features and compared with molecular profiling i.e. IDH1/2 following WHO 2021 criteria. Statistical analysis was done with Fisher’s exact test.
RESULTS: IDH mutant gliomas exhibited frequent T2/FLAIR mismatch i.e. 58.3% vs 10.7% in wildtype, which highlights the utility of conventional MRI techniques as a reliable, non-invasive tool for predicting IDH status.
CONCLUSIONS: T2/FLAIR mismatch sign along with conventional MRI features, may serve as a useful non-invasive adjunct, particularly where molecular testing is unavailable.

Publication (Name of Journal)

Northwest Journal of Medical Sciences

DOI

10.69723/njms.04.04.0609

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