Bhandari, Abhishta P., Liong, R., Koppen, J., Murthy, S.V., and Lasocki, A. (2021) Noninvasive determination of IDH and 1p19q status of lower-grade gliomas using MRI radiomics: A systematic review. American Journal of Neuroradiology, 42 (1). pp. 94-101.

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Abstract

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.

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