Intravoxel incoherent motion (IVIM) MRI for predicting IDH mutation status in adult diffuse glioma: a systematic review and diagnostic test accuracy meta-analysis.
Sono Khan, Jacob Stasso, Gerd Melkus et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and diagnostic test accuracy meta-analysis assessed IVIM MRI parameters for predicting IDH mutation status in adults with diffuse glioma. Thirteen studies were included, with nine contributing to at least one meta-analysis. The diffusion coefficient (D) had the most consistent accuracy: across 7 studies and 499 patients, pooled sensitivity was 0.808 (95% confidence interval [CI] 0.735-0.864), specificity was 0.762 (95% CI 0.696-0.817), and summary AUC was 0.849 (95% CI 0.804-0.884). Evidence certainty was low for D and very low for D* and f.
Key findings
- For D, pooled sensitivity was 0.808 (95% confidence interval [CI] 0.735-0.864), specificity was 0.762 (95% CI 0.696-0.817), and summary AUC was 0.849 (95% CI 0.804-0.884).
- D* had an AUC of 0.727 across 7 studies; f had an AUC of 0.764 across 6 studies and directionally inconsistent findings.
- All 13 studies had high risk of bias for the index test because thresholds were selected post hoc.
Why it matters
IVIM MRI may provide information relevant to IDH mutation status, with D showing the strongest and most consistent diagnostic performance among the assessed parameters. However, tumour type and grade were confounded with molecular status, so observed IVIM differences cannot be considered IDH-specific. This distinction matters when interpreting imaging as a potential marker of tumour biology.
What to keep in mind
Evidence certainty was low for D and very low for D* and f. Post hoc thresholds and substantial variation in b-value schemes, fitting methods, ROI definitions, and thresholds limit confidence and clinical translation.