Predicting IDH mutation status as well as Ki-67 and p53 expression in high-grade gliomas using amide proton transfer-weighted and arterial spin labeling MRI

This study aimed to explore the efficiency of APT imaging and ASL perfusion for evaluating IDH mutation status as well as Ki-67 and p53 expression in patients with high-grade gliomas. Sixty patients with newly diagnosed HGGs were retrospectively analyzed. All subjects were divided into IDH mutation subgroups, Ki-67 index subgroups, and p53 expression subgroups based on the pathological results. rAPTw and rCBF values were compared among different molecular types. ROC curve analysis was used to assess the predictive ability of imaging parameters. Our results showed that significant differences in rAPTw and rCBF values were observed between IDH mutation subgroups and Ki-67 expression subgroups. rAPTw and rCBF values showed no significant association with p53 expression. The AUC of rAPTw and rCBF for predicting IDH mutation status were 0.854 and 0.87, respectively; for Ki-67 index, the AUC values were 0.75 and 0.727, respectively. Combined use of rAPTw and rCBF values showed better predictive ability for IDH mutation and Ki-67 expression status compared to their individual predictive ability. In conclusion, APTw and ASL could be valuable MRI biomarkers for identifying IDH mutation status and Ki-67 index in HGGs, but they may not be useful for assessing p53 expression.