Structural and Advanced Imaging in Predicting MGMT Promoter Methylation of Primary Glioblastoma: a Region of Interest Based Analysis

Overview

Journal BMC Cancer

Publisher Biomed Central

Specialty Oncology

Date 2018 Feb 23

PMID 29467012

Citations 47

Authors

Yu Han

Lin-Feng Yan

Xi-Bin Wang

Ying-Zhi Sun

Xin Zhang

Zhi-Cheng Liu

Hai-Yan Nan

Yu-Chuan Hu

Yang Yang

Jin Zhang

Ying Yu

Qian Sun

Qiang Tian

Bo Hu

Gang Xiao

Wen Wang

Guang-Bin Cui

Affiliations

Soon will be listed here.

Abstract

Background: The methylation status of oxygen 6-methylguanine-DNA methyltransferase (MGMT) promoter has been associated with treatment response in glioblastoma(GBM). Using pre-operative MRI techniques to predict MGMT promoter methylation status remains inconclusive. In this study, we investigated the value of features from structural and advanced imagings in predicting the methylation of MGMT promoter in primary glioblastoma patients.

Methods: Ninety-two pathologically confirmed primary glioblastoma patients underwent preoperative structural MR imagings and the efficacy of structural image features were qualitatively analyzed using Fisher's exact test. In addition, 77 of the 92 patients underwent additional advanced MRI scans including diffusion-weighted (DWI) and 3-diminsional pseudo-continuous arterial spin labeling (3D pCASL) imaging. Apparent diffusion coefficient (ADC) and relative cerebral blood flow (rCBF) values within the manually drawn region-of-interest (ROI) were calculated and compared using independent sample t test for their efficacies in predicting MGMT promoter methylation. Receiver operating characteristic curve (ROC) analysis was used to investigate the predicting efficacy with the area under the curve (AUC) and cross validations. Multiple-variable logistic regression model was employed to evaluate the predicting performance of multiple variables.

Results: MGMT promoter methylation was associated with tumor location and necrosis (P < 0.05). Significantly increased ADC value (P < 0.001) and decreased rCBF (P < 0.001) were associated with MGMT promoter methylation in primary glioblastoma. The ADC achieved the better predicting efficacy than rCBF (ADC: AUC, 0.860; sensitivity, 81.1%; specificity, 82.5%; vs rCBF: AUC, 0.835; sensitivity, 75.0%; specificity, 78.4%; P = 0.032). The combination of tumor location, necrosis, ADC and rCBF resulted in the highest AUC of 0.914.

Conclusion: ADC and rCBF are promising imaging biomarkers in clinical routine to predict the MGMT promoter methylation in primary glioblastoma patients.

Citing Articles

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Relationship between glioblastoma location and O-methylguanine-DNA methyltransferase promoter methylation percentage.

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