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This study characterizes the CNS imaging manifestations of pediatric MOGAD. The authors also identify the clinical and imaging variables associated with relapse. There is an age-dependent imaging phenotype at presentation and first relapse, and older age at presentation is associated with shorter time to relapse.

The T2-FLAIR mismatch sign on MR imaging, usually determined by visual assessment, is a highly specific imaging biomarker of IDH-mutant astrocytomas. The authors of this study quantified the degree of T2-FLAIR mismatch in nonenhancing diffuse gliomas. Thresholds of ≥42% T2-FLAIR mismatch volume classified IDH-mutant astrocytoma with a specificity/sensitivity of 100%/19.6% (TCIA) and 100%/31.6% (institutional). They also found that grades 3–4 compared with grade 2 IDH-mutant astrocytomas (P<.05) had a higher percentage T2-FLAIR mismatch volume.