Perfusion parameters derived from MRI for preoperative prediction of IDH mutation and MGMT promoter methylation status in glioblastomas
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Quantitative Immunohistochemistry of the Cellular Microenvironment in Patient Glioblastoma Resections
Published on: July 31, 2017
Jun Lu1, Xiang Li1, Hailiang Li1
1Department of Radiology, The Affiliated Tumor Hospital of Zhengzhou University & Henan Cancer Hospital, China.
Purpose:
To investigate the feasibility for preoperative prediction of IDH mutation and MGMT promoter methylation status in glioblastomas(GBMs) by intravoxel incoherent motion(IVIM) and dynamic susceptibility contrast(DSC).
Methods:
Preoperative IVIM and DSC images of 71 patients(IDH mutation:45, IDH wildtype: 26; MGMT methylation: 31, MGMT unmethylation:40) with glioblastomas were analyzed retrospectively. Perfusion parameters including microcirculation perfusion coefficient(D*), perfusion fraction(f), cerebral blood volume(CBV) and cerebral blood flow(CBF) were measured. Corrected perfusion parameters containing corrected perfusion coefficient(ADCperf) and simplified perfusion fraction(SPF) were from the simplified IVIM with 3 b values. Correlations among parameters were analyzed by Spearman correlation. All parameters were compared with Mann-Whitney U test. Univariate and multivariate logistic regression models were constructed. The receiver operating characteristic(ROC) curve was analyzed.
Results:
The IVIM parameters showed merely moderate correlations with CBV and showed no correlation with CBF. IDH mutation GBMs showed lower D*, ADCperf, SPF, CBV and higher f than IDH wildtype GBMs(all p < 0.05). D* was the independent predictor for IDH mutation with the highest AUC of 0.912(95%CI: 0.821-0.966). The D*, ADCperf, SPF and CBV of MGMT promoter methylation GBMs were lower than unmethylation GBMs while f was higher(all p < 0.05). Multivariate model showed the highest prediction efficacy for MGMT promoter methylation with an AUC of 0.915(95%CI: 0.824-0.968). The CBF was not useful in distinguishing IDH mutation and MGMT promoter methylation status(p = 0.055, 0.215).
Conclusion:
IDH mutation and MGMT promoter methylation status in GBMs can be assessed effectively by IVIM and DSC. Besides, D* was the independent predictor of IDH mutation status.
Insights
Intravoxel incoherent motion (IVIM) and dynamic susceptibility contrast (DSC) imaging can predict IDH mutation and MGMT promoter methylation in glioblastomas. The microcirculation perfusion coefficient (D*) is a key predictor for IDH mutation status.
Area of Science:
- Neuroimaging
- Oncology
- Radiology
Background:
- Glioblastomas (GBMs) are aggressive primary brain tumors.
- Accurate preoperative determination of IDH mutation and MGMT promoter methylation status is crucial for treatment planning and prognosis.
- Current methods often require invasive tissue biopsy.
Purpose of the Study:
- To assess the feasibility of using intravoxel incoherent motion (IVIM) and dynamic susceptibility contrast (DSC) imaging for preoperative prediction of IDH mutation and MGMT promoter methylation in GBMs.
- To identify imaging parameters that correlate with these molecular subtypes.
Main Methods:
- Retrospective analysis of preoperative IVIM and DSC images from 71 GBM patients.
- Measurement of perfusion parameters including D*, f, CBV, and CBF, as well as corrected parameters ADCperf and SPF.
- Statistical analysis using correlation, Mann-Whitney U test, logistic regression, and ROC curve analysis.
Main Results:
- IVIM parameters showed moderate correlation with CBV but not CBF.
- IDH wildtype GBMs exhibited distinct perfusion parameters (lower D*, ADCperf, SPF, CBV; higher f) compared to IDH-mutated GBMs.
- D* emerged as an independent predictor for IDH mutation status with an AUC of 0.912.
- MGMT promoter methylated GBMs showed lower D*, ADCperf, SPF, CBV and higher f compared to unmethylated GBMs.
- A multivariate model achieved an AUC of 0.915 for predicting MGMT promoter methylation.
- CBF was not a significant differentiator for either IDH mutation or MGMT methylation status.
Conclusions:
- IVIM and DSC imaging are effective non-invasive tools for assessing IDH mutation and MGMT promoter methylation status in GBMs.
- The microcirculation perfusion coefficient (D*) is a significant independent predictor of IDH mutation status.
- These imaging techniques hold promise for improving preoperative characterization of GBMs, potentially reducing the need for biopsies.
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