Abstract
The study by Onishi et al. (2024) investigates the correlation between the T2-FLAIR mismatch sign and CDKN2A status in non-enhancing astrocytoma, IDH-mutant. Through the use of radiological and molecular pathological analyses, the research explores the potential of T2-FLAIR mismatch as an imaging biomarker for predicting CDKN2A-intact astrocytomas. Immunohistochemical staining and next-generation sequencing were employed to confirm molecular diagnosis, enhancing the study's robustness. While the findings contribute significantly to preoperative diagnostics and treatment planning, limitations exist. The relatively small sample size (31 patients) and exclusion of gadolinium-enhancing astrocytomas may restrict the generalizability of the results. Additionally, variation in imaging protocols and the retrospective nature of the study limit the overall impact. Future research with a larger cohort, standardized imaging protocols, and a prospective design is recommended to validate the clinical utility of T2-FLAIR mismatch in differentiating CDKN2A status in astrocytomas.
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