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29.08.2019 | Oncology

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

verfasst von: 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

Erschienen in: European Radiology | Ausgabe 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 (nCBF_CE and nCBF_NE). 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

nCBF_CE 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.

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Titel: Arterial spin labeling perfusion-weighted imaging aids in prediction of molecular biomarkers and survival in glioblastomas
verfasst von: 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
Publikationsdatum: 29.08.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 2/2020
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-019-06379-2

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