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European Radiology
Published in: European Radiology 2/2020

01-02-2020 | Glioblastoma | Oncology

Arterial spin labeling perfusion-weighted imaging aids in prediction of molecular biomarkers and survival in glioblastomas

Authors: Roh-Eul Yoo, Tae Jin Yun, Inpyeong Hwang, Eun Kyoung Hong, Koung Mi Kang, Seung Hong Choi, Chul-Kee Park, Jae-Kyung Won, Ji-hoon Kim, Chul-Ho Sohn

Published in: European Radiology | Issue 2/2020

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Abstract

Objectives

Prediction of progression-free survival (PFS) and overall survival (OS) and early identification of molecular biomarkers with prognostic information are clinically important in glioblastoma (GBM) patients. We aimed to explore the utility of arterial spin labeling perfusion-weighted imaging (ASL-PWI) in the prediction of molecular biomarkers and survival in GBM patients.

Methods

We retrospectively analyzed 149 consecutive GBM patients, who had undergone maximal surgical resection or biopsy followed by concurrent chemoradiotherapy and adjuvant chemotherapy using temozolomide between November 2010 and June 2016. On preoperative ASL-PWI, cerebral blood flow (CBF) within contrast-enhancing (CE) and nonenhancing (NE) portions were evaluated both qualitatively (perfusion pattern[CE] and perfusion pattern[NE]) and quantitatively (nCBFCE and nCBFNE). ASL-PWI findings were correlated with molecular biomarkers, including isocitrate dehydrogenase (IDH) and O6-methylguanine-DNA methyltransferase (MGMT) methylation statuses, and survival, using the Mann-Whitney U-test, Spearman rank correlation, Kaplan-Meier analysis, and receiver operating characteristics analysis.

Results

nCBFCE was significantly higher in the IDH wild-type group than in the IDH mutant group (p = .013) and in the MGMT unmethylated group than in the methylated group (p = .047). Areas under the receiver operating characteristic curve were 0.678 for IDH mutation (p = .022) and 0.601 for MGMT promoter methylation (p = .043). Hyperperfusion was associated with the shortest median PFS for both perfusion pattern[CE] (7.6 months) and perfusion pattern[NE] (4.0 months). The perfusion pattern[NE] remained an independent predictor for PFS and OS even after adjusting for clinical and molecular predictors, unlike perfusion pattern[CE].

Conclusions

ASL-PWI can aid to predict survival and molecular biomarkers including IDH mutation and MGMT promoter methylation statuses in GBM patients.

Key Points

• ASL-PWI can aid to predict survival in GBM patients.
• ASL-PWI can aid to predict IDH and MGMT promoter methylation statuses in GBM.
Appendix
Available only for authorised users
Literature
1.
Cancer Genome Atlas Research N (2008) Comprehensive genomic characterization defines human glioblastoma genes and core pathways. Nature 455:1061–1068CrossRef
2.
Frattini V, Trifonov V, Chan JM et al (2013) The integrated landscape of driver genomic alterations in glioblastoma. Nat Genet 45:1141–1149CrossRef
3.
Parsons DW, Jones S, Zhang X et al (2008) An integrated genomic analysis of human glioblastoma multiforme. Science 321:1807–1812CrossRef
4.
Verhaak RG, Hoadley KA, Purdom E et al (2010) Integrated genomic analysis identifies clinically relevant subtypes of glioblastoma characterized by abnormalities in PDGFRA, IDH1, EGFR, and NF1. Cancer Cell 17:98–110CrossRef
5.
Belden CJ, Valdes PA, Ran C et al (2011) Genetics of glioblastoma: a window into its imaging and histopathologic variability. Radiographics 31:1717–1740CrossRef
6.
Esteller M, Garcia-Foncillas J, Andion E et al (2000) Inactivation of the DNA-repair gene MGMT and the clinical response of gliomas to alkylating agents. N Engl J Med 343:1350–1354CrossRef
7.
Hegi ME, Diserens AC, Gorlia T et al (2005) MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med 352:997–1003CrossRef
8.
9.
Yamashita K, Hiwatashi A, Togao O et al (2016) MR imaging-based analysis of glioblastoma multiforme: estimation of IDH1 mutation status. AJNR Am J Neuroradiol 37:58–65CrossRef
10.
Heiland DH, Demerath T, Kellner E et al (2017) Molecular differences between cerebral blood volume and vessel size in glioblastoma multiforme. Oncotarget 8:11083–11093PubMed
11.
Gupta A, Young RJ, Shah AD et al (2015) Pretreatment dynamic susceptibility contrast MRI perfusion in glioblastoma: prediction of EGFR gene amplification. Clin Neuroradiol 25:143–150CrossRef
12.
Ryoo I, Choi SH, Kim JH et al (2013) Cerebral blood volume calculated by dynamic susceptibility contrast-enhanced perfusion MR imaging: preliminary correlation study with glioblastoma genetic profiles. PLoS One 8:e71704CrossRef
13.
Qiao XJ, Ellingson BM, Kim HJ et al (2015) Arterial spin-labeling perfusion MRI stratifies progression-free survival and correlates with epidermal growth factor receptor status in glioblastoma. AJNR Am J Neuroradiol 36:672–677CrossRef
14.
Yoo RE, Choi SH, Cho HR et al (2013) Tumor blood flow from arterial spin labeling perfusion MRI: a key parameter in distinguishing high-grade gliomas from primary cerebral lymphomas, and in predicting genetic biomarkers in high-grade gliomas. J Magn Reson Imaging 38:852–860CrossRef
15.
Jain R, Poisson L, Narang J et al (2013) Genomic mapping and survival prediction in glioblastoma: molecular subclassification strengthened by hemodynamic imaging biomarkers. Radiology 267:212–220CrossRef
16.
Jain R, Poisson LM, Gutman D et al (2014) Outcome prediction in patients with glioblastoma by using imaging, clinical, and genomic biomarkers: focus on the nonenhancing component of the tumor. Radiology 272:484–493CrossRef
17.
Law M, Young RJ, Babb JS et al (2008) Gliomas: predicting time to progression or survival with cerebral blood volume measurements at dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging. Radiology 247:490–498CrossRef
18.
Wen PY, Macdonald DR, Reardon DA et al (2010) Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol 28:1963–1972CrossRef
19.
Man MZ, Dyson G, Johnson K, Liao B (2004) Evaluating methods for classifying expression data. J Biopharm Stat 14:1065–1084CrossRef
20.
Ducray F, Marie Y, Sanson M (2009) IDH1 and IDH2 mutations in gliomas. N Engl J Med 360:2248–2249 author reply 2249CrossRef
21.
Ichimura K, Pearson DM, Kocialkowski S et al (2009) IDH1 mutations are present in the majority of common adult gliomas but rare in primary glioblastomas. Neuro Oncol 11:341–347CrossRef
22.
Myung JK, Cho HJ, Park CK, Kim SK, Phi JH, Park SH (2012) IDH1 mutation of gliomas with long-term survival analysis. Oncol Rep 28:1639–1644CrossRef
23.
Kickingereder P, Sahm F, Radbruch A et al (2015) IDH mutation status is associated with a distinct hypoxia/angiogenesis transcriptome signature which is non-invasively predictable with rCBV imaging in human glioma. Sci Rep 5:16238CrossRef
24.
Chahal M, Xu Y, Lesniak D et al (2010) MGMT modulates glioblastoma angiogenesis and response to the tyrosine kinase inhibitor sunitinib. Neuro Oncol 12:822–833CrossRef
25.
Burger PC, Heinz ER, Shibata T, Kleihues P (1988) Topographic anatomy and CT correlations in the untreated glioblastoma multiforme. J Neurosurg 68:698–704CrossRef
26.
Parsa AT, Wachhorst S, Lamborn KR et al (2005) Prognostic significance of intracranial dissemination of glioblastoma multiforme in adults. J Neurosurg 102:622–628CrossRef
27.
Oh J, Sahgal A, Sanghera P et al (2011) Glioblastoma: patterns of recurrence and efficacy of salvage treatments. Can J Neurol Sci 38:621–625CrossRef
28.
Wick W, Stupp R, Beule AC et al (2008) A novel tool to analyze MRI recurrence patterns in glioblastoma. Neuro Oncol 10:1019–1024CrossRef
29.
Warmuth C, Gunther M, Zimmer C (2003) Quantification of blood flow in brain tumors: comparison of arterial spin labeling and dynamic susceptibility-weighted contrast-enhanced MR imaging. Radiology 228:523–532CrossRef
30.
Detre JA, Leigh JS, Williams DS, Koretsky AP (1992) Perfusion imaging. Magn Reson Med 23:37–45CrossRef
31.
Williams DS, Detre JA, Leigh JS, Koretsky AP (1992) Magnetic resonance imaging of perfusion using spin inversion of arterial water. Proc Natl Acad Sci U S A 89:212–216CrossRef
Metadata
Title
Arterial spin labeling perfusion-weighted imaging aids in prediction of molecular biomarkers and survival in glioblastomas
Authors
Roh-Eul Yoo
Tae Jin Yun
Inpyeong Hwang
Eun Kyoung Hong
Koung Mi Kang
Seung Hong Choi
Chul-Kee Park
Jae-Kyung Won
Ji-hoon Kim
Chul-Ho Sohn
Publication date
01-02-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06379-2

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