Clinical and diffusion parameters may noninvasively predict TERT promoter mutation status in grade II meningiomas - 16/03/21

Doi : 10.1016/j.neurad.2021.02.007

Ilah Shin ^a, Yae Won Park ^a,⁎ , Sung Soo Ahn ^a, Seok-Gu Kang ^b, Jong Hee Chang ^b, Se Hoon Kim ^c, Seung-Koo Lee ^a
^a Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, South Korea
^b Department of Neurosurgery, Yonsei University College of Medicine, Seoul, South Korea
^c Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea

^⁎Corresponding author at: Department of Radiology, Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea.Department of RadiologyResearch Institute of Radiological Science and Center for Clinical Imaging Data ScienceYonsei University College of Medicine50-1 Yonsei-roSeodaemun-guSeoul120-752South Korea

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Graphical abstract

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Highlights

•	The presence of TERTp mutation in meningioma has shown to be associated with worse prognosis.
•	Conventional imaging features showed no significant predictive abililty of TERTp mutation status in grade 2 meningioma.
•	Older age and lower ADC 10th percentile were indenpendent variables for predicting TERTp mutation status in grade 2 meningiomas.

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Abstract

Background and purpose

Increasing evidence suggests that genomic and molecular markers need to be integrated in grading of meningioma. Telomerase reverse transcriptase promoter (TERTp) mutation is receiving attention due to its clinical relevance in the treatment of meningiomas. The predictive ability of conventional and diffusion MRI parameters for determining the TERTp mutation status in grade II meningiomas has yet been identified.

Material and methods

In this study, 63 patients with surgically confirmed grade II meningiomas (56 TERTp wildtype, 7 TERTp mutant) were included. Conventional imaging features were qualitatively assessed. The maximum diameter, volume of the tumors and histogram parameters from the apparent diffusion coefficient (ADC) were assessed. Independent clinical and imaging risk factors for TERTp mutation were investigated using multivariable logistic regression. The discriminative value of the prediction models with and without imaging features was evaluated.

Results

In the univariable regression, older age (odds ratio [OR] = 1.13, P = 0.005), larger maximum diameter (OR = 1.09, P = 0.023), larger volume (OR = 1.04, P = 0.014), lower mean ADC (OR = 0.02, P = 0.025), and lower ADC 10th percentile (OR = 0.01, P = 0.014) were predictors of TERTp mutation. In multivariable regression, age (OR = 1.13, P = 0.009) and ADC 10th percentile (OR = 0.01, P = 0.038) were independent predictors of variables for predicting the TERTp mutation status. The performance of the prediction model increased upon inclusion of imaging parameters (area under the curves of 0.86 and 0.91, respectively, without and with imaging parameters).