Diagnostic Accuracy of APTw and NOEw MRI Metrics for IDH Mutation and 1p/19q Codeletion Prediction in Gliomas
Abstract
Isocitrate dehydrogenase (IDH) mutation and 1p/19q codeletion are key molecular markers for glioma classification. Amide proton transfer weighted (APTw) and nuclear Overhauser effect–weighted (NOEw) markers showed promise for glioma characterization, by probing protein‐related tissue properties. However, their interpretation is confounded by direct water saturation, macromolecules (semi‐solid magnetization transfer—ssMT), and T 1 relaxation. Here, we aimed to assess the performance of three APTw and NOEw metrics—uncorrected, spillover/ssMT‐corrected (FMC), and fully spillover/ssMT‐ and T 1 ‐corrected (FMTC)—for glioma stratification. Fifty patients with suspected gliomas were prospectively enrolled (12 IDH‐wild‐type, 38 IDH‐mutant, of which 21 with 1p/19q codeletion). Acquisitions were performed at 3 T using a 3D gradient echo readout with chemical exchange saturation transfer ( B 1 = 2 μT for APTw, 0.6 μT for NOEw; T 1sat = 2 s), WASABI (WAter Shift And B1) for B 0 / B 1 mapping, and saturation recovery for T 1 mapping. Glioma subtypes were compared using metrics extracted from manually segmented masks, using two‐tailed Mann–Whitney U tests, and the Benjamini–Hochberg false discovery rate (FDR) correction. Effect sizes were quantified using Cliff's δ with 95% bootstrap confidence intervals and classification performance was assessed by receiver operating characteristic analyses (area under the curve, AUC). IDH‐mutant and wild‐type gliomas differed significantly for the uncorrected APTw metric ( p = 0.005, AUC = 0.79), with stronger discrimination following correction—APTw‐FMC ( p < 0.001, AUC = 0.94) and APTw‐FMTC ( p < 0.001, AUC = 0.96), both with large effect sizes. Only APTw‐FMTC distinguished 1p/19q codeleted from non‐codeleted gliomas before FDR correction (uncorrected p = 0.01, AUC = 0.74). The NOEw metrics did not differ between any molecular subgroups, likely due to limited sensitivity of this contrast at 3 T. These results suggest that correcting for fluid, ssMT, and T 1 effects enhances the accuracy of APTw metrics, offering a more robust and biophysically grounded approach to noninvasive glioma diagnosis.
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BibTeX
@article{cadin2026diagnostic,
title = {{Diagnostic Accuracy of APTw and NOEw MRI Metrics for IDH Mutation and 1p/19q Codeletion Prediction in Gliomas}},
author = {Capucine Cadin and Stefano Casagranda and François Xavier Lejeune and Marianne Golse and Bertrand Mathon and Ottavia Dipasquale and Christos Papageorgakis and Mauro Zucchelli and Emmanuel Mandonnet and Stéphane Lehéricy and Franck Bielle and Marc Sanson and Patrick Liebig and Moritz Zaiss and Lucia Nichelli and Francesca Branzoli},
journal = {NMR in Biomedicine},
year = {2026},
month = aug,
doi = {10.1002/nbm.70372},
url = {https://hal.science/hal-05732885v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Diagnostic Accuracy of APTw and NOEw MRI Metrics for IDH Mutation and 1p/19q Codeletion Prediction in Gliomas
AU - Capucine Cadin
AU - Stefano Casagranda
AU - François Xavier Lejeune
AU - Marianne Golse
AU - Bertrand Mathon
AU - Ottavia Dipasquale
AU - Christos Papageorgakis
AU - Mauro Zucchelli
AU - Emmanuel Mandonnet
AU - Stéphane Lehéricy
AU - Franck Bielle
AU - Marc Sanson
AU - Patrick Liebig
AU - Moritz Zaiss
AU - Lucia Nichelli
AU - Francesca Branzoli
PY - 2026
DA - 2026/08/07
JO - NMR in Biomedicine
DO - 10.1002/nbm.70372
UR - https://hal.science/hal-05732885v1
AB - Isocitrate dehydrogenase (IDH) mutation and 1p/19q codeletion are key molecular markers for glioma classification. Amide proton transfer weighted (APTw) and nuclear Overhauser effect–weighted (NOEw) markers showed promise for glioma characterization, by probing protein‐related tissue properties. However, their interpretation is confounded by direct water saturation, macromolecules (semi‐solid magnetization transfer—ssMT), and T 1 relaxation. Here, we aimed to assess the performance of three APTw and NOEw metrics—uncorrected, spillover/ssMT‐corrected (FMC), and fully spillover/ssMT‐ and T 1 ‐corrected (FMTC)—for glioma stratification. Fifty patients with suspected gliomas were prospectively enrolled (12 IDH‐wild‐type, 38 IDH‐mutant, of which 21 with 1p/19q codeletion). Acquisitions were performed at 3 T using a 3D gradient echo readout with chemical exchange saturation transfer ( B 1 = 2 μT for APTw, 0.6 μT for NOEw; T 1sat = 2 s), WASABI (WAter Shift And B1) for B 0 / B 1 mapping, and saturation recovery for T 1 mapping. Glioma subtypes were compared using metrics extracted from manually segmented masks, using two‐tailed Mann–Whitney U tests, and the Benjamini–Hochberg false discovery rate (FDR) correction. Effect sizes were quantified using Cliff's δ with 95% bootstrap confidence intervals and classification performance was assessed by receiver operating characteristic analyses (area under the curve, AUC). IDH‐mutant and wild‐type gliomas differed significantly for the uncorrected APTw metric ( p = 0.005, AUC = 0.79), with stronger discrimination following correction—APTw‐FMC ( p < 0.001, AUC = 0.94) and APTw‐FMTC ( p < 0.001, AUC = 0.96), both with large effect sizes. Only APTw‐FMTC distinguished 1p/19q codeleted from non‐codeleted gliomas before FDR correction (uncorrected p = 0.01, AUC = 0.74). The NOEw metrics did not differ between any molecular subgroups, likely due to limited sensitivity of this contrast at 3 T. These results suggest that correcting for fluid, ssMT, and T 1 effects enhances the accuracy of APTw metrics, offering a more robust and biophysically grounded approach to noninvasive glioma diagnosis.
SN - 0952-3480
SN - 1099-1492
ER -