Diagnostic Accuracy of APTw and NOEw MRI Metrics for IDH Mutation and 1p/19q Codeletion Prediction in Gliomas

Cadin C, Casagranda S, Lejeune FX, Golse M, Mathon B, Dipasquale O, Papageorgakis C, Zucchelli M, Mandonnet E, Lehéricy S, Bielle F, Sanson M, Liebig P, Zaiß M, Nichelli L, Branzoli F (2026)

Publication Type: Journal article

Publication year: 2026

Journal

NMR in Biomedicine Wiley

Book Volume: 39

Article Number: e70372

Journal Issue: 9

DOI: 10.1002/nbm.70372

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 T1 relaxation. Here, we aimed to assess the performance of three APTw and NOEw metrics—uncorrected, spillover/ssMT-corrected (FMC), and fully spillover/ssMT- and T1-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 (B1 = 2 μT for APTw, 0.6 μT for NOEw; T1sat = 2 s), WASABI (WAter Shift And B1) for B0/B1 mapping, and saturation recovery for T1 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 T1 effects enhances the accuracy of APTw metrics, offering a more robust and biophysically grounded approach to noninvasive glioma diagnosis.

Authors with CRIS profile

Moritz Zaiß Professur für Multimodale Bildgebung in der klinischen Forschung

Involved external institutions

Sorbonne Université FR France (FR) Olea Medical - Improved Diagnosis for Life FR France (FR) Institut du Cerveau et de la Moelle Epinière (ICM) FR France (FR) Pitié-Salpêtrière University Hospital / Hôpital universitaire Pitié-Salpêtrière FR France (FR) Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal FR France (FR)

How to cite

APA:

Cadin, C., Casagranda, S., Lejeune, F.X., Golse, M., Mathon, B., Dipasquale, O.,... Branzoli, F. (2026). Diagnostic Accuracy of APTw and NOEw MRI Metrics for IDH Mutation and 1p/19q Codeletion Prediction in Gliomas. NMR in Biomedicine, 39(9). https://doi.org/10.1002/nbm.70372

MLA:

Cadin, Capucine, et al. "Diagnostic Accuracy of APTw and NOEw MRI Metrics for IDH Mutation and 1p/19q Codeletion Prediction in Gliomas." NMR in Biomedicine 39.9 (2026).

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