The role of T2-FLAIR mismatch sign in the diagnosis of adult gliomas

• Autor(a) principal: Ricardo André Marques Mocho
• Data de Publicação: 2023
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://hdl.handle.net/10216/150289
• topic: Medicina clínica; Clinical medicine

T2-FLAIR mismatch sign is a highly specific radiological sign for IDH mutation, specifically IDH-mutated 1p19q non-codeleted gliomas. The aim of this study was to evaluate the diagnostic performance of this sign and possible association with other tumor imaging features in gliomas. We retrospectively selected 49 adult patients with histopathologic diagnosis of diffuse glioma and available pre-operative MRI. T2-FLAIR mismatch sign was observed in 6 cases (12,24%): two grade 2 astrocytomas, two grade 4 astrocytomas and two grade 2 oligodendrogliomas. T2-FLAIR mismatch sign was a marker for IDH mutation with 54.5% sensitivity, 100% specificity, 100% positive predictive value and 88% negative predictive value; Subventricular zone involvement was significantly associated with T2-FLAIR mismatch sign (p=0.010). This study reinforces the diagnostic potential and clinical applicability of the T2-FLAIR mismatch sign, especially in combination with other radiogenomic tools, and reveals a possible connection between T2-FLAIR mismatch-positive gliomas, subventricular zone involvement and a different origin stem cell.