Imaging features associated with H3 K27-altered and H3 G34-mutant gliomas: a narrative systematic review.

Lasocki, Arian; Abdalla, Gehad; Chow, Geoffrey; Thust, Stefanie C.

Abstract

Background
Advances in molecular diagnostics accomplished the discovery of two malignant glioma entities harboring alterations in the H3 histone: diffuse midline glioma, H3 K27-altered and diffuse hemispheric glioma, H3 G34-mutant. Radiogenomics research, which aims to correlate tumor imaging features with genotypes, has not comprehensively examined histone-altered gliomas (HAG). The aim of this research was to synthesize the current published data on imaging features associated with HAG.

Methods
A systematic search was performed in March 2022 using PubMed and the Cochrane Library, identifying studies on the imaging features associated with H3 K27-altered and/or H3 G34-mutant gliomas.

Results
Forty-seven studies fulfilled the inclusion criteria, the majority on H3 K27-altered gliomas. Just under half (21/47) were case reports or short series, the remainder being diagnostic accuracy studies. Despite heterogeneous methodology, some themes emerged. In particular, enhancement of H3 K27M-altered gliomas is variable and can be less than expected given their highly malignant behavior. Low apparent diffusion coefficient values have been suggested as a biomarker of H3 K27-alteration, but high values do not exclude this genotype. Promising correlations between high relative cerebral blood volume values and H3 K27-alteration require further validation. Limited data on H3 G34-mutant gliomas suggest some morphologic overlap with 1p/19q-codeleted oligodendrogliomas.

Conclusions
The existing data are limited, especially for H3 G34-mutant gliomas and artificial intelligence techniques. Current evidence indicates that imaging-based predictions of HAG are insufficient to replace histological assessment. In particular, H3 K27-altered gliomas should be considered when occurring in typical midline locations irrespective of enhancement characteristics.

Citation

Lasocki, A., Abdalla, G., Chow, G., & Thust, S. C. (2022). Imaging features associated with H3 K27-altered and H3 G34-mutant gliomas: a narrative systematic review. Cancer Imaging, 22, Article 63. https://doi.org/10.1186/s40644-022-00500-3

• Journal Article Type: Article
• Acceptance Date: Oct 23, 2022
• Online Publication Date: Nov 17, 2022
• Publication Date: Nov 17, 2022
• Deposit Date: May 7, 2025
• Publicly Available Date: May 16, 2025
• Journal: Cancer Imaging
• Print ISSN: 1470-7330
• Electronic ISSN: 1470-7330
• Publisher: BioMed Central
• Peer Reviewed: Peer Reviewed
• Volume: 22
• Article Number: 63
• DOI: https://doi.org/10.1186/s40644-022-00500-3
• Keywords: Magnetic resonance imaging, Radiogenomics, H3 K27M-altered glioma, H3 G34-mutant glioma
• Public URL: https://nottingham-repository.worktribe.com/output/20567528
• Publisher URL: https://cancerimagingjournal.biomedcentral.com/articles/10.1186/s40644-022-00500-3
• PMID: 36397143
• Additional Information: Received: 30 August 2022; Accepted: 23 October 2022; First Online: 17 November 2022; : ; : Ethics committee approval was not required by our institutions.; : Not applicable.; : Nil.