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CT- and MRI-detected calcification to predict 1p/19q codeletion status in gliomas: a systematic review and meta-analysis
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DOI：10.1186/s12885-026-16730-8.png)
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Abstract
En 中文
Adult diffuse lower-grade gliomas (LGGs, WHO grades 2–3) are heterogeneous CNS tumors. The 1p/19q codeletion defines oligodendrogliomas (IDHmut-Codel) and predicts better prognosis. Noninvasive imaging biomarkers could aid preoperative tumor characterization, particularly when molecular testing is limited. To systematically evaluate the diagnostic performance of calcifications on CT and MRI as a predictor of 1p/19q codeletion status in gliomas. Seven electronic databases were systematically searched up to August 2025. Studies evaluating calcifications on CT or MRI for predicting 1p/19q codeletion status were included, with FISH, PCR, or NGS as reference standards. Ten studies comprising 1,256 patients met inclusion criteria. Pooled sensitivity, specificity, diagnostic odds ratios (DOR), and hierarchical summary receiver operating characteristic area under the curve (HSROC-AUC) were calculated using bivariate random-effects meta-analysis. Calcifications showed pooled sensitivity of 0.45 (95% CI: 0.38–0.53) and specificity of 0.93 (95% CI: 0.88–0.95), with a DOR of 12.0 (95% CI: 6.41–22.46) and HSROC-AUC of 0.76 (95% CI: 0.46–0.94). The high specificity indicates that the presence of calcification strongly supports 1p/19q codeletion, whereas the lower sensitivity indicates that its absence should not be used to exclude codeletion. Heterogeneity was related to variations in imaging protocols and difficulties differentiating calcifications from hemorrhage or microbleeds across studies. Calcifications on CT and MRI are a reliable noninvasive marker for identifying IDHmut-Codel gliomas and excluding IDHmut-Noncodel tumors. Their detection provides clinically relevant information for preoperative decision-making, particularly in resource-limited settings. Combining calcification assessment with other imaging features may further improve diagnostic accuracy.
Keywords:
1p/19q codeletion
Calcifications
CT
MRI
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