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BMC Cancer
Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Research article

Structural and advanced imaging in predicting MGMT promoter methylation of primary glioblastoma: a region of interest based analysis

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

Published in: BMC Cancer | Issue 1/2018

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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.
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Metadata
Title
Structural and advanced imaging in predicting MGMT promoter methylation of primary glioblastoma: a region of interest based analysis
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
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-018-4114-2

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