Imaging Parameters of High Grade Gliomas in Relation to the MGMT Promoter Methylation Status: The CT, Diffusion Tensor Imaging, and Perfusion MR Imaging

Neuroradiology. 2012 Jun;54(6):555-63. doi: 10.1007/s00234-011-0947-y. Epub 2011 Aug 11.

Abstract

Introduction: We hypothesized that methyl-guanine methyl transferase (MGMT) promoter methylation status, a predictor of the chemosensitivity for high grade gliomas (HGGs), may be associated with computed tomography (CT)/magnetic resonance (MR) imaging variables.

Methods: Out of 38 consecutive patients with HGGs, 24 patients whose MGMT promoter methylation status was available [12 men and 12 women; median age, 49 years; age range, 22-79 years; WHO grade III (n = 7), WHO grade IV (n = 17)] were enrolled retrospectively. CT attenuation, apparent diffusion coefficient (ADC), fractional anisotropy (FA), and relative cerebral blood volume (rCBV) were measured for enhancing tumors. Qualitative imaging features were also analyzed. Mann-Whitney and Fisher's exact tests were used to evaluate relationships between MGMT promoter methylation status and imaging variables.

Results: Maximum CT attenuation was significantly lower in the methylated MGMT promoter group than that in the unmethylated MGMT promoter group (30.3 ± 9.5 HU versus 39.2 ± 4.7 HU, respectively, p = 0.009). While ADC values tended to be higher in the methylated group than in the unmethylated group (p = 0.055), ADC ratio was significantly higher, and the FA and FA ratios were significantly lower in the methylated group than in the unmethylated group (p = 0.032, p = 0.006 and p = 0.007, respectively). In contrast, rCBV ratio did not differ between the two groups (p = 0.380). Regarding imaging features, only ill-defined margin was seen more frequently in the methylated group than in the unmethylated group (45.5% versus 7.7%, respectively, p = 0.048).

Conclusion: Preoperative imaging can predict MGMT promoter methylation status, which is of paramount importance for predicting treatment response to chemotherapy with an alkylating agent.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / genetics*
  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / genetics*
  • DNA Methylation
  • DNA Modification Methylases / genetics*
  • DNA Repair Enzymes / genetics*
  • Diagnostic Imaging / methods*
  • Diffusion Magnetic Resonance Imaging / methods
  • Female
  • Glioma / diagnosis*
  • Glioma / genetics*
  • Humans
  • Magnetic Resonance Angiography / methods
  • Male
  • Middle Aged
  • Promoter Regions, Genetic
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / methods
  • Tumor Suppressor Proteins / genetics*
  • Young Adult

Substances

  • Biomarkers, Tumor
  • Tumor Suppressor Proteins
  • DNA Modification Methylases
  • MGMT protein, human
  • DNA Repair Enzymes