Decoding the Heterogeneity of Glioma IDH Genotyping by DCE-MRI of Spatial Habitat Analysis: A Feasibility Study

Motivation: To evaluate dynamic contrast enhanced (DCE) MRI for assessing heterogeneity in glioma IDH genotyping and derive a combined map. Goal(s): To predict specific tumor areas and to guide biopsy and precision molecular typing therapy. Approach: Whole tumor volumes were delineated on DCE images, and voxel-wise clustering of each quantitative imaging map identified five combined physiologic MRI habitats. Results: DCE-Ktrans within necrosis subregion (mask1) emerged as the best parameter to identify IDH status (AUC=0.824, p＜0.001), while DCE-Ktrans within mild reinforcement region (mask 2) was positively correlated with Ki-67(r=0.473, p=0.001) and DCE-Ve of middle reinforcement (mask 4) was positively correlated with microvessel density (MVD)(r=-0.549, p＜0.001). Impact: Based on the habitat analysis of MR perfusion imaging, glioma was divided into different sub-regions, which reflected biological information such as necrosis, hypoxia, and angiogenesis, predicted molecular classification and guided clinical biopsy or surgical sampling accurately to guide precision therapy.