Predicting IDH mutation status in grade II gliomas using amide proton transfer-weighted (APTw) MRI

Magn Reson Med. 2017 Sep;78(3):1100-1109. doi: 10.1002/mrm.26820. Epub 2017 Jul 16.


Purpose: To assess the amide proton transfer-weighted (APTw) MRI features of isocitrate dehydrogenase (IDH)-wildtype and IDH-mutant grade II gliomas and to test the hypothesis that the APTw signal is a surrogate imaging marker for identifying IDH mutation status preoperatively.

Methods: Twenty-seven patients with pathologically confirmed low-grade glioma, who were previously scanned at 3T, were retrospectively analyzed. The Mann-Whitney test was used to evaluate relationships between APTw intensities for IDH-mutant and IDH-wildtype groups, and receiver operator characteristic (ROC) analysis was used to assess the diagnostic performance of APTw.

Results: Based on histopathology and molecular analysis, seven cases were diagnosed as IDH-wildtype grade II gliomas and 20 cases as IDH-mutant grade II gliomas. The maximum and minimum APTw values, based on multiple regions of interest, as well as the whole-tumor histogram-based mean and 50th percentile APTw values, were significantly higher in the IDH-wildtype gliomas than in the IDH-mutant groups. This corresponded to the areas under the ROC curves of 0.89, 0.76, 0.75, and 0.75, respectively, for the prediction of the IDH mutation status.

Conclusion: IDH-wildtype lesions typically were associated with relatively high APTw signal intensities as compared with IDH-mutant lesions. The APTw signal could be a valuable imaging biomarker by which to identify IDH1 mutation status in grade II gliomas. Magn Reson Med 78:1100-1109, 2017. © 2017 International Society for Magnetic Resonance in Medicine.

Keywords: CEST; IDH; amide proton transfer imaging-weighted; glioma; imaging biomarker.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Biomarkers, Tumor / genetics*
  • Brain Neoplasms / chemistry
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / genetics
  • Female
  • Glioma / chemistry
  • Glioma / diagnostic imaging*
  • Glioma / genetics
  • Humans
  • Isocitrate Dehydrogenase / genetics*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Molecular Imaging / methods*
  • Mutation / genetics
  • Protons
  • Retrospective Studies


  • Biomarkers, Tumor
  • Protons
  • Isocitrate Dehydrogenase