Another advantage for identifying H3 K27M status is that it may be a potentially novel target for immunotherapy for diffuse midline glioma (DMG) ( 2, 5– 7). A previous study showed that patients with DMG-M had a worse prognosis (with a 2-year survival rate of less than 10%) than those with a diffuse midline glioma, H3 K27M wild (DMG-W) regardless of age, tumor location, or histopathological grading ( 3, 4).
The term DMG-M is suggested to be only used for tumors that are diffuse, midline gliomas with an H3 K27M mutation, and not for other tumors with the H3 K27M-mutant. It describes a group of tumors with mutations in either H3F3A or HIST1H3B/C ( 2, 3). T2W sequences may be valuable, and cystic formation a useful MRI biomarker, for diagnosing brain DMG-M.ĭiffuse midline gliomas with the H3 K27M mutation (diffuse midline glioma, H3 K27M-mutant) (DMG-M) is a newly defined entity in the 2016 World Health Organization (WHO) classification of central nervous system tumors ( 1). Among these features, only cystic formation showed a significant difference between the two types of tumors (OR=7.800, 95% CI 1.476–41.214, p=0.024).Ĭonclusions: DMGs with and without the H3 K27M mutation shared similar MRI characteristics. Thereafter, four visually accessible features related to T2WI were further extracted and analyzed. The feature selection results showed that few features from T2-weighted images (T2WI) were useful for differentiating DMG-M and DMG-W tumors. Principal component analysis showed that there were obvious overlaps in the first two principal components for both DMG-M and DMG-W tumors. Results: Patients with DMG-M were younger than those with diffuse midline gliomas with H3 K27M wild (DMG-W) (median, 25.5 and 48 years old, respectively p=0.005). Based on the results, related visually accessible features of the tumors were further evaluated. Principal component analysis, univariate analysis, and three other feature selection methods, including variance thresholding, recursive feature elimination, and the elastic net, were used to analyze the radiomic features. A total of 272 radiomic features were initially extracted from MR images of each tumor.
Materials and Methods: Thirty patients with diffuse midline gliomas, including 16 with the H3 K27M mutant and 14 with wild type tumors, were retrospectively included in this study. Objectives: To explore the magnetic resonance imaging (MRI) characteristics of brain diffuse midline gliomas with the H3 K27M mutation (DMG-M) using radiomics. Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Qian Li, Fei Dong, Biao Jiang and Minming Zhang *
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