MGMT Promoter Methylation Status in Initial and Recurrent Glioblastoma: Correlation Study with DWI and DSC PWI Features

• Published in: American journal of neuroradiology : AJNR Vol. 42; no. 5; pp. 853 - 860
• Main Authors: Choi, H J, Choi, S H, You, S-H, Yoo, R-E, Kang, K M, Yun, T J, Kim, J-H, Sohn, C-H, Park, C-K, Park, S-H
• Format: Journal Article
• Language: English
• Published: United States American Society of Neuroradiology 01-05-2021
• Subjects: Adult; Adult Brain; Aged; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - genetics; Correlation of Data; Diffusion Magnetic Resonance Imaging - methods; DNA Methylation; DNA Modification Methylases - genetics; DNA Repair Enzymes - genetics; Female; Functional; Glioblastoma - diagnostic imaging; Glioblastoma - genetics; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Molecular Imaging; Neoplasm Recurrence, Local; Promoter Regions, Genetic; Retrospective Studies; Tumor Suppressor Proteins - genetics
• ISSN: 0195-6108; 1936-959X
• DOI: 10.3174/AJNR.A7004

(
) promoter methylation status in primary and recurrent glioblastoma may change during treatment. The purpose of this study was to correlate
promoter methylation status changes with DWI and DSC PWI features in patients with recurrent glioblastoma after standard treatment.
Between January 2008 and November 2016, forty patients with histologically confirmed recurrent glioblastoma were enrolled. Patients were divided into 3 groups according to the
promoter methylation status for the initial and recurrent tumors: 2 groups whose
promoter methylation status remained, group methylated (
= 13) or group unmethylated (
= 18), and 1 group whose
promoter methylation status changed from methylated to unmethylated (
= 9). Normalized ADC and normalized relative CBV values were obtained from both the enhancing and nonenhancing regions, from which histogram parameters were calculated. The ANOVA and the Kruskal-Wallis test followed by post hoc tests were performed to compare histogram parameters among the 3 groups. The
test and Mann-Whitney
test were used to compare parameters between group methylated and group methylated to unmethylated. Receiver operating characteristic curve analysis was used to measure the predictive performance of the normalized relative CBV values between the 2 groups.
Group methylated to unmethylated showed significantly higher means and 90th and 95th percentiles of the cumulative normalized relative CBV values of the nonenhancing region of the initial tumor than group methylated and group unmethylated (all
< .05). The mean normalized relative CBV value of the nonenhancing region of the initial tumor was the best predictor of methylation status change (
< .001), with a sensitivity of 77.78% and specificity of 92.31% at a cutoff value of 2.594.
promoter methylation status might change in recurrent glioblastoma after standard treatment. The normalized relative CBV values of the nonenhancing region at the first preoperative MR imaging were higher in the
promoter methylation change group from methylation to unmethylation in recurrent glioblastoma.