Structural and advanced imaging in predicting MGMT promoter methylation of primary glioblastoma: a region of interest based analysis
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
Yu Han
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University)
Lin-Feng Yan
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University)
Xi-Bin Wang
Department of Medical Image Diagnosis, Hanzhong Central Hospital
Ying-Zhi Sun
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University)
Xin Zhang
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University)
Zhi-Cheng Liu
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University)
Hai-Yan Nan
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University)
Yu-Chuan Hu
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University)
Yang Yang
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University)
Jin Zhang
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University)
Ying Yu
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University)
Qian Sun
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University)
Qiang Tian
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University)
Bo Hu
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University)
Gang Xiao
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University)
Wen Wang
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University)
Guang-Bin Cui
Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, the Military Medical University of PLA Airforce (Fourth Military Medical University)
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.
