Objective To investigate the value of apparent diffusion coefficient(ADC)histogram parameters in the e-valuation of mutations of H3K27M in children with high grade diffuse midline glioma(DMG).Methods The clinical pathological and imaging data of 54 patients with DMG confirmed by pathology in our hospital were retrospectively collect-ed.According to the mutation status of H3K27M,they were divided into H3K27M mutant group(n=39)and H3K27M wild-type group(n=15).Firevoxel software was used to segmentate the area of interest(ROI)of entire lesion in each lay-er of the ADC image for full-volume histogram analysis.The generated ADC histogram parameters include ADC minimum value(ADCmin),ADC mean value(ADCmean),ADC maximum value(ADCmax),skewness,kurtosis,standard deviation,var-iation,coefficient of variation,entropy,ADC 1st percentile(ADC1％),ADC 10th percentile(ADC10％),ADC 50th per-centile(ADC50％),ADC 90th percentile(ADC90％),and ADC 99th percentile(ADC99％).Mann-Whitney U test was used to compare these histogram parameters between groups.Receiver operating characteristic curve(ROC)was drawn for parameters with statistically significant differences between groups(P≤ 0.05),and area under ROC curve(AUC),sensi-tivity,specificity and Yoden index were calculated.Results The H3K27M mutant had significantly lower ADCmean,ADCmax,ADC10％,ADC50％,ADC90％and ADC99％values than those of the H3K27M wild type(all P≤ 0.05),while the H3K27M mutant had significantly higher skewness and kurtosis values than those of the H3K27M wild type(all P≤0.05).The ROC analysis showed that the optimal parameter in evaluating H3K27M mutant and H3K27M wild type was ADCmax,and the AUC,sensitivity,specificity and Yoden index were 0.846(0.722-0.930),66.7％,93.3％and 0.600,respectively.Conclusion The full-volume ADC histogram parameter can effectively evaluate the H3K27M mutation status of DMG,which is helpful for clinicians to evaluate prognosis and individualized treatment for patient.
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