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05.04.2016 | Neuro | Ausgabe 1/2017

European Radiology 1/2017

Different diagnostic values of imaging parameters to predict pseudoprogression in glioblastoma subgroups stratified by MGMT promoter methylation

Zeitschrift:
European Radiology > Ausgabe 1/2017
Autoren:
Ra Gyoung Yoon, Ho Sung Kim, Wooyul Paik, Woo Hyun Shim, Sang Joon Kim, Jeong Hoon Kim
Wichtige Hinweise
Ra Gyoung Yoon and Wooyul Paik contributed equally to this work.

Abstract

Objectives

The aim of this study was to determine whether diffusion and perfusion imaging parameters demonstrate different diagnostic values for predicting pseudoprogression between glioblastoma subgroups stratified by O6-mythylguanine-DNA methyltransferase (MGMT) promoter methylation status.

Methods

We enrolled seventy-five glioblastoma patients that had presented with enlarged contrast-enhanced lesions on magnetic resonance imaging (MRI) one month after completing concurrent chemoradiotherapy and undergoing MGMT promoter methylation testing. The imaging parameters included 10 or 90 % histogram cutoffs of apparent diffusion coefficient (ADC10), normalized cerebral blood volume (nCBV90), and initial area under the time signal-intensity curve (IAUC90). The results of the areas under the receiver operating characteristic curve (AUCs) with cross-validation were compared between MGMT methylation and unmethylation groups.

Results

MR imaging parameters demonstrated a trend toward higher accuracy in the MGMT promoter methylation group than in the unmethylation group (cross-validated AUCs = 0.70–0.95 and 0.56–0.87, respectively). The combination of MGMT methylation status with imaging parameters improved the AUCs from 0.70 to 0.75–0.90 for both readers in comparison with MGMT methylation status alone. The probability of pseudoprogression was highest (95.7 %) when nCBV90 was below 4.02 in the MGMT promoter methylation group.

Conclusions

MR imaging parameters could be stronger predictors of pseudoprogression in glioblastoma patients with the methylated MGMT promoter than in patients with the unmethylated MGMT promoter.

Key Points

The glioblastoma subgroup was stratified according to MGMT promoter methylation status.
Diagnostic values of diffusion and perfusion parameters for predicting pseudoprogression were compared.
Imaging parameters showed higher diagnostic accuracy in the MGMT promoter methylation group.
Imaging parameters were independent to MGMT promoter methylation status for predicting pseudoprogression.
Imaging biomarkers might demonstrate different diagnostic values according to MGMT promoter methylation.

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