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Abstract #3586

Reevaluating the Role of T2/FLAIR Mismatch Sign: Improving Diagnostic Accuracy With Qualitative MRI Features?

Klara Willms1,2, Marc von Reppert1,2, Jan Lost1, Niklas Tillmanns1, Sara Merkaj1, Anita Huttner3, Elisabeth Schrickel4, Fatima Memon1, and Mariam Aboian1
1Radiology, Yale School of Medicine, New Haven, CT, United States, 2Radiology, University of Leipzig, Leipzig, Germany, 3Pathology, Yale School of Medicine, New Haven, CT, United States, 4Neuroradiology, The Ohio State University School of Medicine, Columbus, OH, United States

Synopsis

Keywords: Tumors (Pre-Treatment), Cancer, IDH-Mutation, 1p/19q Codeletion

Motivation: There is a critical need for improved diagnostic precision in distinguishing between IDH-mutant, 1p/19q non-codeleted astrocytomas and 1p/19q co-deleted oligodendrogliomas. While the T2/FLAIR-mismatch sign is specific for IDH-mutant astrocytomas, its limited sensitivity calls for enhanced diagnostic methods in glioma cohorts.

Goal(s): To evaluate the role of T2/FLAIR-mismatch in combination with qualitative VASARI features to classify IDH-mutant glioma.

Approach: We analyzed VASARI features and the presence of T2/FLAIR-mismatch in 179 IDH-mutant gliomas and determined the predictive accuracy of these features.

Results: Findings indicate the limitations of the T2/FLAIR-mismatch sign for accurate preoperative diagnosis, emphasizing the need for refined noninvasive methods to enhance diagnostic accuracy.

Impact: This research underscores the critical need for improved diagnostic tools in distinguishing glioma subtypes, as the T2/FLAIR-mismatch sign exhibits limitations, risking misclassification. Addressing these challenges is essential for accurate patient management and treatment planning in the context of IDH-mutant gliomas.

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Keywords