Characterizing asymmetric deep medullary veins by 7.0T susceptibility-weighted MRI to predict glioma genotype and Ki-67 index

Motivation: Knowing the genotype of gliomas is critical for prognostic assessment and treatment selection. 7.0T susceptibility-weighted imaging (SWI) allows visualizing the deep medullary veins and provides additional metabolic information. Goal(s): We used the asymmetric deep medullary vein (ADMV) sign on 7.0T SWI to predict glioma isocitrate dehydrogenase mutation status and Ki-67 expression level. Approach: We assessed the ADMV sign and conventional morphological and screening features (P<0.1) via multivariate logistic regression to evaluate the predicted performance. Results: The ADMV sign on 7.0T images was independently associated with isocitrate dehydrogenase mutation status and Ki-67 index and improved the images’ diagnostic efficacy. Impact: Discovery of the ADMV sign as an imaging biomarker and the advantages of 7.0T MRI may help markedly improve the diagnosis and management of gliomas and may have broader applications in medical imaging and biomarker development.