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The Initial Area Under the Curve Derived from Dynamic Contrast-Enhanced MRI Improves Prognosis Prediction in Glioblastoma with Unmethylated MGMT Promoter

Authors
 Y.S. Choi  ;  S.S. Ahn  ;  H.-J. Lee  ;  J.H. Chang  ;  S.-G. Kang  ;  E.H. Kim  ;  S.H. Kim  ;  S.-K. Lee 
Citation
 American Journal of Neuroradiology, Vol.38(8) : 1528-1535, 2017 
Journal Title
 American Journal of Neuroradiology 
ISSN
 0195-6108 
Issue Date
2017
MeSH
Adult ; Aged ; Area Under Curve ; Brain Neoplasms/diagnostic imaging* ; Brain Neoplasms/genetics ; Brain Neoplasms/mortality ; DNA Methylation/genetics ; DNA Modification Methylases/genetics ; DNA Repair Enzymes/genetics ; Disease-Free Survival ; Female ; Glioblastoma/diagnostic imaging* ; Glioblastoma/genetics ; Glioblastoma/mortality ; Humans ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Neuroimaging/methods* ; Prognosis ; Promoter Regions, Genetic/genetics ; ROC Curve ; Reproducibility of Results ; Retrospective Studies ; Tumor Suppressor Proteins/genetics
Abstract
BACKGROUND AND PURPOSE: Although perfusion and permeability MR parameters have known to have prognostic value, they have reproducibility issues. Our aim was to evaluate whether the initial area under the time-to-signal intensity curve (IAUC) derived from dynamic contrast-enhanced MR imaging can improve prognosis prediction in patients with glioblastoma with known MGMT status. MATERIALS AND METHODS: We retrospectively examined 88 patients with glioblastoma who underwent preoperative dynamic contrast-enhanced MR imaging. The means of IAUC values at 30 and 60 seconds (IAUC30mean and IAUC60mean) were extracted from enhancing tumors. The prognostic values of IAUC parameters for overall survival and progression-free survival were assessed with log-rank tests, according to the MGMT status. Multivariate overall survival and progression-free survival models before and after adding the IAUC parameters as covariates were explored by net reclassification improvement after receiver operating characteristic analysis for 1.5-year overall survival and 1-year progression-free survival and by random survival forest. RESULTS: High IAUC parameters were associated with worse overall survival and progression-free survival in the unmethylated MGMT group, but not in the methylated group. In the unmethylated MGMT group, 1.5-year overall survival and 1-year progression-free survival prediction improved significantly after adding IAUC parameters (overall survival area under the receiver operating characteristic curve, 0.86; progression-free survival area under the receiver operating characteristic curve, 0.74-0.76) to the model with other prognostic factors (overall survival area under the receiver operating characteristic curve, 0.81; progression-free survival area under the receiver operating characteristic curve, 0.69; P < .05 for all) except in the case of IAUC60mean for 1-year progression-free survival prediction (P = .059). Random survival forest models indicated that the IAUC parameters were the second or most important predictors in the unmethylated MGMT group, except in the case of the IAUC60mean for progression-free survival. CONCLUSIONS: IAUC can be a useful prognostic imaging biomarker in patients with glioblastoma with known MGMT status, improving prediction of glioblastoma prognosis with the unmethylated MGMT promoter status.
Full Text
http://www.ajnr.org/content/38/8/1528
DOI
10.3174/ajnr.A5265
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
강석구(Kang, Seok Gu) ORCID logo https://orcid.org/0000-0001-5676-2037
김세훈(Kim, Se Hoon) ORCID logo https://orcid.org/0000-0001-7516-7372
김의현(Kim, Eui Hyun) ORCID logo https://orcid.org/0000-0002-2523-7122
안성수(Ahn, Sung Soo) ORCID logo https://orcid.org/0000-0002-0503-5558
이승구(Lee, Seung Koo) ORCID logo https://orcid.org/0000-0001-5646-4072
이호준(Lee, Ho Joon)
장종희(Chang, Jong Hee)
최윤성(Choi, Yoon Seong)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160649
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