Article Figures & Data
Figures
- Fig 1.
Brain MRE experimental setup and image processing. A, Brain MRE soft pillow driver placed within the 8-channel MR imaging head coil and positioned beneath the head to induce shear waves in the brain. B, Axial T2 FLAIR image of a glioblastoma, IDH1 wild type (51-year-old man), with tumor denoted by a solid white line, and peritumoral edema, by a black dotted line. MRE shear wave image (C) and elastogram (D) or stiffness map display a soft tumor with a stiffness of 1.1 kPa in the tumor compared with 3.5 kPa in a size-matched region of unaffected white matter on the contralateral hemisphere.
- Fig 2.
A, Gliomas are softer than normal brain tissue, compared with size-matched ROIs in the unaffected contralateral white matter (asterisk indicates P < .001). An outlier is indicated by a plus sign, and whiskers on the boxplot indicate the 25th and 75th percentiles. B, Glioma stiffness decreases with increasing tumor grade (double asterisks indicate P < .05).
- Fig 3.
A, Comparison of the tumor stiffness (|G*|) between IDH1–R132H (n = 12) and wild type (WT) gliomas (n = 6). Gliomas with wild type IDH1 were significantly softer than gliomas with a mutation in IDH1–R132H (asterisk indicates P = .007). The whiskers on the boxplot indicate the 25th and 75th percentiles. B, Tumor shear stiffness by tumor grade for all patients in this study including IDH1–R132H mutated tumors (white circles) and wild type IDH1 (WT, black circles). The horizontal dotted line at 2.0 kPa separates the IDH1-mutated and wild type gliomas with a sensitivity and specificity of 83% and 100%. There is one secondary IDH1-mutated GBM with a low |G*| = 1.5 kPa, and it may be unique due to the secondary disease subtype.
- Fig 4.
Stiffness heterogeneity of gliomas. Noncontrast, axial MRE magnitude images (left column), shear wave images (middle column), and elastograms (right column) for 2 patients with grade III gliomas. Images in the top row are from an oligodendroglioma with an IDH1–R132H mutation with |G*| = 3.3 kPa (a 31-year-old man), while the bottom row is from a diffuse astrocytoma with wild type IDH1 with |G*| = 1.7 kPa (a 44-year-old woman).
Tables
Patient and tumor characteristics
No. Sex Age (yr) Tumor Size (cm3) Location Contrast Enhancement IDH1 Mutated? 1p/19q Codeleted? Histologic and Genetic Classification Grade 1 F 36 16.8 Left parietal None Yes Yes Oligodendroglioma, IDH mutant and 1p19q codeleted II 2 M 39 60.6 Right temporal None Yes No Diffuse astrocytoma, IDH mutant II 3 M 34 14.7 Left frontal Partial Yes No Diffuse astrocytoma, IDH mutant II 4 M 31 54.7 Right frontal None Yes Yes Oligodendroglioma, IDH mutant and 1p19q codeleted II 5 M 65 4.1 Left frontal None Yes Yes Oligodendroglioma II 6 M 31 37.5 Left frontal None Yes Yes Oligodendroglioma, IDH mutant and 1p19q codeleted III 7 F 35 66.9 Right frontal None Yes No Diffuse astrocytoma, IDH mutant III 8 F 37 71.0 Left temporal Partial Yes No Diffuse astrocytoma, IDH mutant III 9 M 51 59.9 Left temporal None Yes Yes Oligodendroglioma, IDH mutant and 1p19q codeleted III 10 F 60 117.0 Right frontal Partial Yes No Diffuse astrocytoma, IDH mutant III 11 F 44 75.6 Right frontal None No No Diffuse astrocytoma, IDH wild type III 12 M 33 38.9 Left frontal Partial No No Diffuse astrocytoma, IDH wild type III 13 F 28 5.5 Left frontal Partial Yes – Glioblastoma IV 14 M 25 98.3 Right frontal Partial Yes – Glioblastoma IV 15 M 51 27.6 Left postcentral gyrus Complete No – Glioblastoma IV 16 M 46 9.5 Left temporal None No – Glioblastoma IV 17 M 68 7.3 Left frontal Complete No – Glioblastoma IV 18 M 55 37.1 Right thalamus Complete No – Glioblastoma IV Note:— – indicates not applicable.
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