Noninvasive Determination of IDH and 1p19q Status of Lower-grade Gliomas Using MRI Radiomics: A Systematic Review

AJNR Am J Neuroradiol. 2021 Jan;42(1):94-101. doi: 10.3174/ajnr.A6875. Epub 2020 Nov 26.


Background: Determination of isocitrate dehydrogenase (IDH) status and, if IDH-mutant, assessing 1p19q codeletion are an important component of diagnosis of World Health Organization grades II/III or lower-grade gliomas. This has led to research into noninvasively correlating imaging features ("radiomics") with genetic status.

Purpose: Our aim was to perform a diagnostic test accuracy systematic review for classifying IDH and 1p19q status using MR imaging radiomics, to provide future directions for integration into clinical radiology.

Data sources: Ovid (MEDLINE), Scopus, and the Web of Science were searched in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Diagnostic Test Accuracy guidelines.

Study selection: Fourteen journal articles were selected that included 1655 lower-grade gliomas classified by their IDH and/or 1p19q status from MR imaging radiomic features.

Data analysis: For each article, the classification of IDH and/or 1p19q status using MR imaging radiomics was evaluated using the area under curve or descriptive statistics. Quality assessment was performed with the Quality Assessment of Diagnostic Accuracy Studies 2 tool and the radiomics quality score.

Data synthesis: The best classifier of IDH status was with conventional radiomics in combination with convolutional neural network-derived features (area under the curve = 0.95, 94.4% sensitivity, 86.7% specificity). Optimal classification of 1p19q status occurred with texture-based radiomics (area under the curve = 0.96, 90% sensitivity, 89% specificity).

Limitations: A meta-analysis showed high heterogeneity due to the uniqueness of radiomic pipelines.

Conclusions: Radiogenomics is a potential alternative to standard invasive biopsy techniques for determination of IDH and 1p19q status in lower-grade gliomas but requires translational research for clinical uptake.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / genetics
  • Brain Neoplasms / pathology
  • Chromosomes, Human, Pair 1 / genetics*
  • Female
  • Glioma / diagnosis*
  • Glioma / genetics
  • Glioma / pathology
  • Humans
  • Isocitrate Dehydrogenase / genetics*
  • Machine Learning*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Mutation


  • Isocitrate Dehydrogenase