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IDH status shapes glioma oncotopy: voxel-wise mapping of 644 adult diffuse gliomas

Background: The aim of this study was to characterize the anatomical and imaging features of adult-type diffuse gliomas across histomolecular subtypes. Methods: Clinical 3-Tesla brain MRI images from 644 patients with pathologically confirmed adult-diffuse glioma before treatment was retrospectively...

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Main Authors: Garhöfer, Freya (Author) , Yun, Yeong Chul (Author) , Wolf, Sabine (Author) , Holz, Katharina (Author) , Jende, Johann (Author) , Hohmann, Anja (Author) , Vollmuth, Philipp (Author) , Bendszus, Martin (Author) , Santarosa, Corrado (Author) , Lövblad, Karl-Olof (Author) , Schlemmer, Heinz-Peter (Author) , Sahm, Felix (Author) , Heiland, Sabine (Author) , Venkataramani, Varun (Author) , Kurz, Felix T. (Author)
Format: Article (Journal)
Language:English
Published: 07 May 2026
In: Neuroradiology
Year: 2026, Volume: 68, Issue: 6, Pages: 1717-1727
ISSN:1432-1920
DOI:10.1007/s00234-026-03991-0
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1007/s00234-026-03991-0
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Author Notes:Freya Garhöfer, Yeong Chul Yun, Sabine Wolf, Katharina Holz, Johann M.E. Jende, Anja Hohmann, Philipp Vollmuth, Martin Bendszus, Corrado Santarosa, Karl-Olof Lövblad, Heinz-Peter Schlemmer, Felix Sahm, Sabine Heiland, Varun Venkataramani, Felix T. Kurz
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Summary:Background: The aim of this study was to characterize the anatomical and imaging features of adult-type diffuse gliomas across histomolecular subtypes. Methods: Clinical 3-Tesla brain MRI images from 644 patients with pathologically confirmed adult-diffuse glioma before treatment was retrospectively evaluated: 527 IDH-wildtype glioblastoma, 71 astrocytoma, and 46 oligodendroglioma. Pre- and post-contrast T1-weighted, T2-weighted and FLAIR sequences were part of the MRI protocol. Contrast-enhancing tumors and non-enhancing lesions (NEL) were automatically segmented using HD-GLIO. We used a voxel-wise Fisher-exact-test followed by random-permutation (ADIFFI) to identify regions with higher occurrence of tumor associated with IDH-mutation status or 1p/19q-codeletion status. Mann-Whitney-U-test was used to compare signal intensities in CET and NEL across the three different subtypes of adult-diffuse glioma investigated here. Results: We observed a significant correlation of IDH-mutant gliomas with a predominance in the frontal lobe adjacent to the rostral extension of the lateral ventricles. IDH-wildtype tumors had larger NEL volumes than IDH-mutant gliomas (p < 0.0001). Signal intensity analysis demonstrated consistently lower T1w and T1-CE values and higher T2w and FLAIR values in IDH-mutant gliomas (all p < 0.0001). Oligodendrogliomas showed higher signal intensity on T1-CE images compared to astrocytomas (p = 0.035). Conclusion: We analyzed a large radio-genomic patient cohort consisting of glioblastoma, astrocytoma and oligodendroglioma. Our findings are in line with previously analyzed smaller patient cohorts. Our findings underline the importance of the IDH-mutation for determining tumor location and potentially point to a cell of origin along the rostral extension of the lateral ventricles.
Item Description:Online veröffentlicht: 07. Mai 2026
Gesehen am 10.08.2026
Physical Description:Online Resource
ISSN:1432-1920
DOI:10.1007/s00234-026-03991-0

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