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• Clinical Articles •
Predictive value of DTI-ALPS combined with FA and standard MRI quantitative parameters for IDH mutation in adult-type diffuse high-grade gliomas
JIN Mingtian  XU Muyuan  HE Hairong  SU Chunqiu  HONG Kexuan  HONG Xunning 

Cite this article as JIN M T, XU M Y, HE H R, et al. Predictive value of DTI-ALPS combined with FA and standard MRI quantitative parameters for IDH mutation in adult-type diffuse high-grade gliomas[J]. Chin J Magn Reson Imaging, 2026, 17(8): 71-79. DOI:10.12015/issn.1674-8034.2026.08.007.


[Abstract] Objective To explore the predictive value of combining diffusion tensor image analysis along the perivascular space (DTI-ALPS), fractional anisotropy (FA) and standard MRI quantitative parameters for isocitrate dehydrogenase (IDH) mutation status in adult-type diffuse high-grade gliomas.Materials and Methods A total of 106 patients with adult-type diffuse high-grade gliomas who underwent standard MRI and diffusion tensor imaging (DTI) examinations and were definitively diagnosed by postoperative histopathological examination were enrolled in this retrospective analysis. The clinical, imaging and pathological data of all patients were collected. Standard MRI quantitative parameters were obtained by layer-by-layer delineation of the entire tumor using 3D-Slicer software. DSI studio software was applied to calculate FA and mean diffusivity (MD) in the tumor and peritumoral edema regions, as well as the ALPS index on the ipsilateral and contralateral sides of the tumor. Clinical data, standard MRI quantitative parameters, DTI metrics and ALPS index were compared between IDH wild-type and IDH-mutant groups. Univariate and multivariate analyses were performed for indicators with statistically significant intergroup differences. Multivariate binary logistic regression analysis was used to identify the optimal diagnostic parameters for predicting IDH mutation status. Receiver operating characteristic (ROC) curves were plotted to evaluate diagnostic efficiency.Results Tumor FA, tumor MD, ipsilateral ALPS index, contralateral ALPS index, tumor parenchymal volume, peritumoral edema volume, tumor-to-edema volume ratio and age were significantly different between the IDH wild-type and IDH-mutant groups (P < 0.05). Multivariate binary logistic regression analysis revealed that age, tumor parenchymal volume, peritumoral edema volume, tumor FA and ipsilateral ALPS index were independent predictors of IDH mutation status. DeLong test indicated that the ipsilateral ALPS index and tumor FA exerted distinct incremental predictive values based on corresponding baseline models. ROC curve analysis demonstrated that the combined model incorporating age, standard MRI quantitative parameters, DTI metrics and ALPS index achieved the optimal predictive performance for IDH mutation status in adult-type diffuse high-grade gliomas. The area under the curve (AUC) was 0.952, with a sensitivity of 89.0%, specificity of 97.0% and accuracy of 93.4%. After 1000 bootstrap internal validation, the corrected 95% confidence interval (CI) of AUC was 0.879 to 0.995. The area under the precision-recall curve (PR-AUC) was 0.933, and the Brier score was 0.062, suggesting favorable model calibration.Conclusions DTI-ALPS combined with FA and standard MRI quantitative parameters shows good efficacy in predicting IDH mutation in adult-type diffuse high-grade gliomas. Ipsilateral ALPS index and tumor FA yield extra diagnostic value and can serve as imaging evidence for preoperative assessment and individualized treatment.
[Keywords] gliomas；magnetic resonance imaging；diffusion tensor imaging；diffusion tensor image analysis along the perivascular space；isocitrate dehydrogenase

JIN Mingtian   XU Muyuan   HE Hairong   SU Chunqiu   HONG Kexuan   HONG Xunning*  

Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China

Corresponding author: HONG X N, E-mail: hongxunning@sina.com

Conflicts of interest   None.

Received  2026-04-02
Accepted  2026-07-14
DOI: 10.12015/issn.1674-8034.2026.08.007
Cite this article as JIN M T, XU M Y, HE H R, et al. Predictive value of DTI-ALPS combined with FA and standard MRI quantitative parameters for IDH mutation in adult-type diffuse high-grade gliomas[J]. Chin J Magn Reson Imaging, 2026, 17(8): 71-79. DOI:10.12015/issn.1674-8034.2026.08.007.

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