Table 1. Genetic mutations in brain tumors with current clinical and imaging implications.
Genetic mutations and clinical imaging implications/associations | ||
---|---|---|
Current implications/associations | Imaging associations | |
IDH1/2 mutations | Oligodendroglial tumors | Minimal or no contrast enhancement |
Positive prognostic factor | Reported detection of 2-HG by MRS | |
Research into hyperpolarized C13 detection in animal models | ||
1p19q deletion | Oligodendroglial tumors | Reported more heterogeneous signal characteristics |
Reported elevated perfusion | ||
MGMT promoter methylation | Pseudo-progression more common | Pseudo-progression more common |
Alkylating agents | ||
ATRX deletion | Astrocytic tumors | |
Not seen with 1p19q deletion | ||
PTEN deletion | Small cell phenotype of glioblastoma with EGFR amplification and 10q loss | Reported increased perfusion in tumors with PTEN mutation, EGFR amplification, unmethylated MGMT promoter |
EGFR amplification | Reported in approximately 40% of glioblastomas | Reported increased perfusion |
Reported lower ADC values, higher enhancing/necrotic volume |
ADC, apparent diffusion coefficient; ATRX, alpha thalassemia-mental retardation syndrome X-linked; C-13, carbon 13; EGFR, epidermal growth factor receptor; IDH, isocitrate dehydrogenase; MGMT, O6-methylguanine-DNA methyl-transferase; MRS, magnetic resonance spectroscopy; PTEN, phosphatase and tensin homolog; 2-HG, 2-hydroxyglutarate