Department of Radiology, The Affiliated Tumor Hospital of Zhengzhou University & Henan Cancer Hospital, China.
Department of Radiology, The Affiliated Tumor Hospital of Zhengzhou University & Henan Cancer Hospital, China.
Magn Reson Imaging. 2021 Nov;83:189-195. doi: 10.1016/j.mri.2021.09.005. Epub 2021 Sep 8.
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).
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(ADC) 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.
The IVIM parameters showed merely moderate correlations with CBV and showed no correlation with CBF. IDH mutation GBMs showed lower D*, ADC, 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*, ADC, 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).
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.
通过体素内不相干运动（IVIM）和动态对比增强磁共振成像（DSC）研究术前预测胶质母细胞瘤（GBM）中 IDH 突变和 MGMT 启动子甲基化状态的可行性。
回顾性分析了 71 例 GBM 患者（IDH 突变：45 例，IDH 野生型：26 例；MGMT 甲基化：31 例，MGMT 非甲基化：40 例）的术前 IVIM 和 DSC 图像。测量了灌注参数，包括微循环灌注系数（D*）、灌注分数（f）、脑血容量（CBV）和脑血流（CBF）。从 3 个 b 值的简化 IVIM 中得到校正灌注参数，包括校正灌注系数（ADC）和简化灌注分数（SPF）。采用 Spearman 相关分析参数之间的相关性。采用 Mann-Whitney U 检验比较各参数。构建单因素和多因素逻辑回归模型。分析受试者工作特征（ROC）曲线。
IVIM 参数与 CBV 仅呈中度相关，与 CBF 无相关性。IDH 突变型 GBM 的 D*、ADC、SPF、CBV 均低于 IDH 野生型 GBM，f 高于 IDH 野生型 GBM（均 P<0.05）。D是 IDH 突变的独立预测因子，AUC 最高为 0.912（95%CI：0.821-0.966）。MGMT 启动子甲基化 GBM 的 D、ADC、SPF 和 CBV 均低于非甲基化 GBM，f 高于非甲基化 GBM（均 P<0.05）。多因素模型对 MGMT 启动子甲基化的预测效能最高，AUC 为 0.915（95%CI：0.824-0.968）。CBF 对区分 IDH 突变和 MGMT 启动子甲基化状态无意义（P=0.055，0.215）。
IVIM 和 DSC 可有效评估 GBM 中 IDH 突变和 MGMT 启动子甲基化状态，D*是 IDH 突变状态的独立预测因子。
