Investigative Magnetic Resonance Imaging

  • 제22권3호
  • /
  • Pages.158-167
  • /
  • 2018
  • /
  • 2384-1095(pISSN)
  • /
  • 2384-1109(eISSN)
대한자기공명의과학회 (Korean Society of Magnetic Resonance in Medicine)
권호 표지
DOI QR코드

DOI QR Code

Dynamic Susceptibility Contrast (DSC) Perfusion MR in the Prediction of Long-Term Survival of Glioblastomas (GBM): Correlation with MGMT Promoter Methylation and 1p/19q Deletions

  • Kwon, Yong Wonn (Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Moon, Won-Jin (Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Park, Mina (Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Roh, Hong Gee (Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Koh, Young Cho (Department of Neurosurgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Song, Sang Woo (Department of Neurosurgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Choi, Jin Woo (Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine)
  • 투고 : 2018.04.04
  • 심사 : 2018.06.28
  • 발행 : 2018.09.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: To investigate the surgical, perfusion, and molecular characteristics of glioblastomas which influence long-term survival after treatment, and to explore the association between MR perfusion parameters and the presence of MGMT methylation and 1p/19q deletions. Materials and Methods: This retrospective study was approved by our institutional review board. A total 43 patients were included, all with pathologic diagnosis of glioblastoma with known MGMT methylation and 1p/19q deletion statuses. We divided these patients into long-term (${\geq}60\;months$, n = 7) and short-term (< 60 months, n = 36) survivors, then compared surgical extent, molecular status, and rCBV parameters between the two groups using Fisher's exact test or Mann-Whitney test. The rCBV parameters were analyzed according to the presence of MGMT methylation and 1p/19q deletions. We investigated the relationship between the mean rCBV and overall survival using linear correlation. Multivariable linear regression was performed in order to find the variables related to overall survival. Results: Long-term survivors (100% [7 of 7]) demonstrated a greater percentage of gross total or near total resection than short-term survivors (54.5% [18 of 33]). A higher prevalence of 1p/19q deletions was also noted among the long-term survivors (42.9% [3 of 7]) than the short-term survivors (0.0% [0 of 36]). The rCBV parameters did not differ between the long-term and short-term survivors. The rCBV values were marginally lower in patients with MGMT methylation and 1p/19q deletions. Despite no correlation found between overall survival and rCBV in the whole group, the short-term survivor group showed negative correlation ($R^2=0.181$, P = 0.025). Multivariable linear regression revealed that surgical extent and 1p/19q deletions, but not rCBV values, were associated with prolonged overall survival. Conclusion: While preoperative rCBV and 1p/19q deletion status are related to each other, only surgical extent and the presence of 1p/19q deletion in GBM patients may predict long-term survival.

키워드

참고문헌

  1. Affronti ML, Heery CR, Herndon JE 2nd, et al. Overall survival of newly diagnosed glioblastoma patients receiving carmustine wafers followed by radiation and concurrent temozolomide plus rotational multiagent chemotherapy. Cancer 2009;115:3501-3511 https://doi.org/10.1002/cncr.24398
  2. Ostrom QT, Bauchet L, Davis FG, et al. Response to "the epidemiology of glioma in adults: a 'state of the science' review". Neuro Oncol 2015;17:624-626 https://doi.org/10.1093/neuonc/nov022
  3. Buckner JC. Factors influencing survival in high-grade gliomas. Semin Oncol 2003;30:10-14 https://doi.org/10.1016/S0093-7754(03)70020-7
  4. Curran WJ Jr, Scott CB, Horton J, et al. Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials. J Natl Cancer Inst 1993;85:704-710 https://doi.org/10.1093/jnci/85.9.704
  5. DeAngelis LM. Brain tumors. N Engl J Med 2001;344:114-123 https://doi.org/10.1056/NEJM200101113440207
  6. Newlands ES, Stevens MF, Wedge SR, Wheelhouse RT, Brock C. Temozolomide: a review of its discovery, chemical properties, pre-clinical development and clinical trials. Cancer Treat Rev 1997;23:35-61 https://doi.org/10.1016/S0305-7372(97)90019-0
  7. Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide forglioblastoma. N Engl J Med 2005;352:987-996 https://doi.org/10.1056/NEJMoa043330
  8. Yung WK, Albright RE, Olson J, et al. A phase II study of temozolomide vs. procarbazine in patients withglioblastoma multiforme at first relapse. Br J Cancer 2000;83:588-593 https://doi.org/10.1054/bjoc.2000.1316
  9. Stupp R, Gander M, Leyvraz S, Newlands E. Current and future developments in the use of temozolomide for the treatment of brain tumours. Lancet Oncol 2001;2:552-560 https://doi.org/10.1016/S1470-2045(01)00489-2
  10. Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 2016;131:803-820 https://doi.org/10.1007/s00401-016-1545-1
  11. Johnson DR, Guerin JB, Giannini C, Morris JM, Eckel LJ, Kaufmann TJ. 2016 updates to the WHO brain tumor classification system: what the radiologist needs to know. Radiographics 2017;37:2164-2180 https://doi.org/10.1148/rg.2017170037
  12. Wesseling P, Capper D. WHO 2016 classification of gliomas. Neuropathol Appl Neurobiol 2018;44:139-150 https://doi.org/10.1111/nan.12432
  13. Hegi ME, Diserens AC, Godard S, et al. Clinical trial substantiates the predictive value of O-6-methylguanine-DNA methyltransferase promoter methylation inglioblastoma patients treated with temozolomide. Clin Cancer Res 2004;10:1871-1874 https://doi.org/10.1158/1078-0432.CCR-03-0384
  14. Zhao J, Ma W, Zhao H. Loss of heterozygosity 1p/19q and survival in glioma: a meta-analysis. Neuro Oncol 2014;16:103-112 https://doi.org/10.1093/neuonc/not145
  15. Moon WJ, Choi JW, Roh HG, Lim SD, Koh YC. 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;54:555-563 https://doi.org/10.1007/s00234-011-0947-y
  16. Kim BS, Seol HJ, Nam DH, et al. Concurrent chemoradiotherapy with temozolomide followed byadjuvant temozolomide for newly diagnosed glioblastoma patients: a retrospective multicenter observation study in Korea. Cancer Res Treat 2017;49:193-203 https://doi.org/10.4143/crt.2015.473
  17. Wesseling P, van den Bent M, Perry A. Oligodendroglioma: pathology, molecular mechanisms and markers. Acta Neuropathol 2015;129:809-827 https://doi.org/10.1007/s00401-015-1424-1
  18. Blanc JL, Wager M, Guilhot J, et al. Correlation of clinical features and methylation status of MGMT gene promoter in glioblastomas. J Neurooncol 2004;68:275-283 https://doi.org/10.1023/B:NEON.0000033385.37098.85
  19. Kim SH, Choi SH, Yoon TJ, et al. Measurement of apparentdiffusion coefficient values from diffusion-weighted MRI: a comparison of manual and semiautomatic segmentationmethods. Investig Magn Reson Imaging 2015;19:88-98 https://doi.org/10.13104/imri.2015.19.2.88
  20. Kim YE, Choi SH, Lee ST, et al. Differentiation between glioblastoma and primary central nervous system lymphoma using dynamic susceptibility contrast-enhanced perfusion MR imaging: comparison study of the manual versus semiautomatic segmentation method. Investig Magn Reson Imaging 2017;21:9-19 https://doi.org/10.13104/imri.2017.21.1.9
  21. Aronen HJ, Gazit IE, Louis DN, et al. Cerebral blood volume maps of gliomas: comparison with tumor grade and histologic findings. Radiology 1994;191:41-51 https://doi.org/10.1148/radiology.191.1.8134596
  22. Bag AK, Cezayirli PC, Davenport JJ, et al. Survival analysis in patients with newly diagnosed primary glioblastoma multiforme using pre- and post-treatment peritumoral perfusion imaging parameters. J Neurooncol 2014;120:361-370 https://doi.org/10.1007/s11060-014-1560-9
  23. Choi SH, Jung SC, Kim KW, et al. Perfusion MRI as the predictive/prognostic and pharmacodynamic biomarkers in recurrent malignant glioma treated with bevacizumab: a systematic review and a time-to-event meta-analysis. J Neurooncol 2016;128:185-194 https://doi.org/10.1007/s11060-016-2102-4
  24. Brown TJ, Brennan MC, Li M, et al. Association of the extent of resection with survival in glioblastoma: a systematic review and meta-analysis. JAMA Oncol 2016;2:1460-1469 https://doi.org/10.1001/jamaoncol.2016.1373
  25. Qaddoumi I, Ellison DW, Morris EB, et al. Dysembryoplastic neuroepithelial tumors and cognitive outcome: cure at a price? Cancer 2010;116:5461-5469 https://doi.org/10.1002/cncr.25528
  26. Cairncross G, Wang M, Shaw E, et al. Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: long-term results of RTOG 9402. J Clin Oncol 2013;31:337- 343
  27. Eckel-Passow JE, Lachance DH, Molinaro AM, et al. Glioma groups based on 1p/19q, IDH, and TERT promoter mutations in tumors. N Engl J Med 2015;372:2499-2508 https://doi.org/10.1056/NEJMoa1407279
  28. Jenkins RB, Blair H, Ballman KV, et al. A t(1;19) (q10;p10) mediates the combined deletions of 1p and 19q and predicts a better prognosis of patients with oligodendroglioma. Cancer Res 2006;66:9852-9861 https://doi.org/10.1158/0008-5472.CAN-06-1796
  29. van den Bent MJ, Brandes AA, Taphoorn MJ, et al. Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC brain tumor group study 26951. J Clin Oncol 2013;31:344-350
  30. Kaneshiro D, Kobayashi T, Chao ST, Suh J, Prayson RA. Chromosome 1p and 19q deletions in glioblastoma multiforme. Appl Immunohistochem Mol Morphol 2009;17:512-516 https://doi.org/10.1097/PAI.0b013e3181a2c6a4
  31. Aum DJ, Kim DH, Beaumont TL, Leuthardt EC, Dunn GP, Kim AH. Molecular and cellular heterogeneity: the hallmark of glioblastoma. Neurosurg Focus 2014;37:E11
  32. Meng W, Jiang Y, Ma J. Is the prognostic significance of O6-methylguanine- DNA methyltransferase promoter methylation equally important in glioblastomas of patients from different continents? A systematic review with meta- analysis. Cancer Manag Res 2017;9:411-425 https://doi.org/10.2147/CMAR.S140447
  33. Stecco A, Amatuzzo P, Sponghini AP, et al. Prognostic value of relative cerebral blood volume (rCBV) in patients with recurrent glioblastoma multiforme treated with bevacizumab. J Neurosurg Sci 2016 [Epub ahead of print]
  34. Law M, Young RJ, Babb JS, et al. Gliomas: predicting time to progression or survival with cerebral blood volume measurements at dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging. Radiology 2008;247:490-498 https://doi.org/10.1148/radiol.2472070898
  35. Sawlani RN, Raizer J, Horowitz SW, et al. Glioblastoma: a method for predicting response to antiangiogenic chemotherapy by using MR perfusion imaging--pilot study. Radiology 2010;255:622-628 https://doi.org/10.1148/radiol.10091341
  36. Cha S, Tihan T, Crawford F, et al. Differentiation of low- grade oligodendrogliomas from low-grade astrocytomas by using quantitative blood-volume measurements derived from dynamic susceptibility contrast-enhanced MR imaging. AJNR Am J Neuroradiol 2005;26:266-273
  37. Jenkinson MD, Smith TS, Joyce KA, et al. Cerebral blood volume, genotype and chemosensitivity in oligodendroglial tumours. Neuroradiology 2006;48:703-713 https://doi.org/10.1007/s00234-006-0122-z
  38. Bonekamp D, Deike K, Wiestler B, et al. Association of overall survival in patients with newly diagnosed glioblastoma with contrast-enhanced perfusion MRI: comparison of intraindividually matched T1 - and T2 (*) -based bolus techniques. J Magn Reson Imaging 2015;42:87-96 https://doi.org/10.1002/jmri.24756

피인용 문헌

  1. Differentiation between Glioblastoma and Solitary Metastasis: Morphologic Assessment by Conventional Brain MR Imaging and Diffusion-Weighted Imaging vol.25, pp.1, 2018, https://doi.org/10.13104/imri.2021.25.1.23