Differentiation between spinal cord diffuse midline glioma with histone H3 K27M mutation and wild type: comparative magnetic resonance imaging

  • Jo Sung Jung
  • Yoon Seong Choi
  • Sung Soo Ahn
  • Seong Yi
  • Se Hoon Kim
  • Seung-Koo LeeEmail author
Spinal Neuroradiology



Diffuse midline glioma with histone H3 K27M mutation is a new entity described in the 2016 update of the World Health Organization Classification of Tumors of the Central Nervous System. The purpose of this study was to evaluate the clinical and imaging characteristics to predict the presence of H3 K27M mutation in spinal cord glioma using a machine learning–based classification model.


A total of 41 spinal cord glioma patients consisting of 24 H3 K27M mutants and 17 wild types were enrolled in this retrospective study. A total of 17 clinical and radiological features were evaluated. The random forest (RF) model was trained with the clinical and radiological features to predict the presence of H3 K27M mutation. The diagnostic ability of the RF model was evaluated using receiver operating characteristic (ROC) analysis. Area under the ROC curves (AUC) was calculated.


MR imaging features of spinal cord diffuse midline gliomas were heterogeneous. Hemorrhage was the only variable that was able to differentiate H3 K27M mutated tumors from wild-type tumors in univariate analysis (p = 0.033). RF classifier yielded 0.632 classification AUC (95% CI, 0.456–0.808), 63.4% accuracy, 45.8% sensitivity, and 88.2% specificity.


Our findings indicate that clinical and radiological features are associated with H3 K27M mutation status in spinal cord glioma.


Diffuse midline glioma Histone H3 K27M Spinal cord glioma Random forest 


Compliance with ethical standards


No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

For this type of retrospective study formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Jo Sung Jung
    • 1
  • Yoon Seong Choi
    • 1
  • Sung Soo Ahn
    • 1
  • Seong Yi
    • 2
  • Se Hoon Kim
    • 3
  • Seung-Koo Lee
    • 1
    Email author
  1. 1.Department of Radiology and Research Institute of Radiological Science, College of MedicineYonsei University College of MedicineSeoulSouth Korea
  2. 2.Department of NeurosurgeryYonsei University College of MedicineSeoulSouth Korea
  3. 3.Department of PathologyYonsei University College of MedicineSeoulSouth Korea

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