Chen Ling, Wu Min, Li Yao, Tang Lifang, Tang Chuyun, Huang Lizhao, Li Tao, Zhu Li
Department of Radiology, Liuzhou Worker's Hospital, Guangxi, China.
Department of Neurosurgery, Liuzhou Worker's Hospital, Guangxi, China.
Brain Behav. 2025 Jan;15(1):e70175. doi: 10.1002/brb3.70175.
Adult glioblastomas (GBMs) are associated with high recurrence and mortality. Personalized treatment based on molecular markers may help improve the prognosis. We aimed to evaluate whether apparent diffusion coefficient (ADC) histogram analysis can better predict MGMT and TERT molecular characteristics and to determine the prognostic relevance of genetic profile in patients with GBM.
MRI, clinical, and pathological data of 79 patients with GBM were retrospectively collected. The ADC values based on histogram analysis were described using 10th percentile (p10), 90th percentile (p90), mean, median, minimum, maximum, skewness, kurtosis, and entropy. The independent-sample t test, linear correlation analysis, receiver operating characteristics (ROC) curve analysis, Kaplan-Meier analysis, and Cox proportional hazard regression were performed.
MGMT promoter methylation and TERT promoter mutation were detected in 53.2% and 44.3% of GBM patients, respectively. The ADC in MGMT promoter unmethylated group was significantly lower than that in the MGMT promoter methylated group (p = 0.005). There were significant differences in ADC, ADC, ADC, and entropy between TERT promoter mutant and wild-type groups. Entropy showed the best diagnostic performance in differentiating between positive and negative TERT groups (AUC = 0.722, p = 0.001). Overall survival (OS) showed a positive correlation with ADC. The TERT promoter mutation was the only independent prognostic factor for GBM.
ADC histogram analysis may be a potential noninvasive biomarker for differentiating MGMT and TERT molecular markers and providing prognostic information for GBM patients.
成人胶质母细胞瘤（GBM）具有高复发率和死亡率。基于分子标志物的个性化治疗可能有助于改善预后。我们旨在评估表观扩散系数（ADC）直方图分析是否能更好地预测MGMT和TERT分子特征，并确定GBM患者基因谱的预后相关性。
回顾性收集79例GBM患者的MRI、临床和病理数据。基于直方图分析的ADC值用第10百分位数（p10）、第90百分位数（p90）、均值、中位数、最小值、最大值、偏度、峰度和熵来描述。进行独立样本t检验、线性相关分析、受试者工作特征（ROC）曲线分析、Kaplan-Meier分析和Cox比例风险回归分析。
GBM患者中MGMT启动子甲基化和TERT启动子突变的检测率分别为53.2%和44.3%。MGMT启动子未甲基化组的ADC显著低于MGMT启动子甲基化组（p = 0.005）。TERT启动子突变组和野生型组之间的ADC、ADC、ADC和熵存在显著差异。熵在区分TERT阳性和阴性组方面表现出最佳的诊断性能（AUC = 0.722，p = 0.001）。总生存期（OS）与ADC呈正相关。TERT启动子突变是GBM唯一的独立预后因素。
ADC直方图分析可能是一种潜在的非侵入性生物标志物，用于区分MGMT和TERT分子标志物，并为GBM患者提供预后信息。
