基于扩散加权成像的生境分析对成人弥漫性胶质瘤异柠檬酸脱氢酶基因突变状态的评估价值OA

Objective:To investigate the diagnostic value of diffusion weighted imaging(DWI)-based habitat imaging for the preoperative assessment of isocitrate dehydrogenase(IDH)mutation status in adult diffuse gliomas.Materials and Methods:A total of 99 adult patients with diffuse gliomas(73 IDH wildtype and 26 IDH mutant)were retrospectively enrolled.Based on the intravoxel incoherent motion(IVIM)and diffusion kurtosis imaging(DKI)models,the perfusion fraction(f),true diffusion coefficient(D),and mean kurtosis(MK)parameters were calculated.K-means clustering was applied to voxel-wise data within the tumor volume of interest(VOI)to construct habitat maps,and the volumetric fraction of each habitat was quantified.Logistic regression was used to develop diffusion parameter model,habitat model,age model and integrated model.The performance of different models was evaluated using five-fold cross-validation.DeLong test was employed to compare the performance of the integrated model with that of the other models.Results:The proportion of Habitat 1(Hypercellular hypoperfusion hyperheterogeneous habitat)was higher in IDH wild-type gliomas compared with IDH mutant gliomas(0.56±0.25 vs.0.30±0.20,P＜0.001),whereas the proportion of Habitat 2(Hypocellular hypoperfusion hypoheterogeneous habitat)was lower(0.39±0.25 vs.0.64±0.21,P＜0.001).DeLong test showed that the integrated model achieved the highest diagnostic performance[AUC=0.902,95％confidence interval(CI):0.759 to 1.000].Shapley additive explanations analysis indicated that age contributed most to model predictions,followed by the proportion of Habitat 1.Conclusions:Habitat imaging based on IVIM and DKI parameters effectively reflects the intratumoral heterogeneity of gliomas.When combined with clinical characteristics,it enables accurate,noninvasive prediction of IDH mutation status,offering a promising imaging biomarker for preoperative molecular subtyping of gliomas.