A three-component multi-b-value diffusion-weighted imaging might be a useful biomarker for detecting microstructural features in gliomas with differences in malignancy and IDH-1 mutation status.

Objectives: The purpose of the study was to explore the performance of a three-component diffusion model in evaluating the degree of malignancy and isocitrate dehydrogenase 1 (IDH-1) gene type of gliomas.

Methods: Overall, 60 patients with gliomas were enrolled. The intermediate and perfusion-related diffusion coefficients (D and D) and fractions of strictly limited, intermediate, and perfusion-related diffusion (F, F, and F) were obtained with a three-component diffusion model. Parameters were also obtained from a diffusion kurtosis model and mono- and biexponential models. All parameters were compared between different tumor grades and IDH-1 gene types. Diagnostic performance and logistic regression analyses were performed.

Results: High-grade gliomas (HGGs) had significantly higher F, F, and D values but significantly lower F and D values than low-grade gliomas (LGGs), and F and F differed significantly among grade II, III, and IV gliomas (p < 0.05 for all). F achieved the highest AUC of 0.872 in differentiating between LGGs and HGGs. Logistic regression analysis revealed that in each model, F, diffusion coefficient (D), apparent diffusion coefficient (ADC), mean diffusivity (MD), and mean kurtosis (MK) were associated with glioma grading. After multiple regression analysis, F remained the only differentiator. Additionally, F and F showed significant differences between IDH-1 mutated and IDH-1 wild-type gliomas (p = 0.007 and 0.01, respectively).

Conclusions: The three-component DWI model served as a useful biomarker for detecting microstructural features in gliomas with different grades and IDH-1 mutation statuses.

Key Points: • The three-component model enables the estimation of an intermediate diffusion component. • The three-component model performed better than the other models in glioma grading and genotyping. • F was useful in evaluating the grade and genotype of gliomas.