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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleAdult Brain
Open Access

MGMT Promoter Methylation Status in Initial and Recurrent Glioblastoma: Correlation Study with DWI and DSC PWI Features

H.J. Choi, S.H. Choi, S.-H. You, R.-E. Yoo, K.M. Kang, T.J. Yun, J.-h. Kim, C.-H. Sohn, C.-K. Park and S.-H. Park
American Journal of Neuroradiology May 2021, 42 (5) 853-860; DOI: https://doi.org/10.3174/ajnr.A7004
H.J. Choi
aFrom the Department of Radiology (H.J.C.), Cha Bundang Medical Center, Cha University, Seongnam, Korea
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S.H. Choi
bDepartment of Radiology (S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
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S.-H. You
cDepartment of Radiology (S.-H.Y.), Korea University Hospital, Seoul, Korea
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R.-E. Yoo
bDepartment of Radiology (S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
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K.M. Kang
bDepartment of Radiology (S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
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T.J. Yun
bDepartment of Radiology (S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
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J.-h. Kim
bDepartment of Radiology (S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
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C.-H. Sohn
bDepartment of Radiology (S.H.C., R.-E.Y., K.M.K., T.J.Y., J.-h.K., C.-H.S.), Seoul National University Hospital, Seoul, Korea
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C.-K. Park
dDepartment of Neurosurgery (C.-K.P.), Seoul National University Hospital, Seoul, Korea
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S.-H. Park
eDepartment of Pathology (S.-H.P.), Seoul National University Hospital, Seoul, Korea
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    FIG 1.

    Study design.

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    FIG 2.

    Comparison of nrCBV histogram parameters across each group of NER in the initial tumor. The mean, 90th percentile, and 95th percentile of the nrCBV values of the NER of the initial tumor were significantly higher in group MU than in group MM and group UU. Asterisks represent statistically significant differences among groups. 90P indicates the 90th percentile; 95P, the 95th percentile.

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    FIG 3.

    FLAIR images (A–C) and nrCBV maps (D–F) with corresponding cumulative histograms (G–I) for representative patients. A, D, G, A 34-year-old woman in group MM. B, E, H, A 37-year-old woman in group UU. C, F, I, A 32-year-old man in group MU. The histogram values (mean, 90th percentile, and 95th percentile) of the nrCBV in the NER of the tumors in group MU are higher than those in group UU or group MM.

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    Table 1:

    Clinical characteristics of the patientsa

    Group MM (n = 13)Group UU (n = 18)Group MU (n = 9)Pb
    Age (yr)49.9 (SD, 14.3)51.6 (SD, 14.5)46.3 (SD, 11.1).61
    Sex.52
        Female7 (53.8%)10 (55.6%)3 (33.3%)
        Male6 (46.2%)8 (44.4%)6 (66.7%)
    IDH 1 or 2 mutation.06
        Negative9 (90.0%)14 (100.0%)6 (66.7%)
        Positive1 (10.0%)0 (0.0%)3 (33.3%)
    EGFR amplification: initial tumor.85
        Negative7 (53.8%)10 (55.6%)4 (44.4%)
        Positive6 (46.2%)8 (44.4%)5 (55.6%)
    EGFR amplification: recurrent tumor.81
        Negative8 (66.7%)10 (55.6%)5 (55.6%)
        Positive4 (33.3%)8 (44.4%)4 (44.4%)
    WHO grade: initial tumor.12
        Grade III anaplastic astrocytoma1 (7.7%)0 (0.0%)2 (22.2%)
        Grade IV glioblastoma12 (92.3%)18 (100.0%)7 (77.8%)
    WHO grade: recurrent tumor
        Grade IV13 (100.0%)18 (100.0%)9 (100.0%)
    Surgical extent.32
        Total resection11 (84.62%)11 (61.11%)7 (77.78%)
        Subtotal resection2 (15.4%)0 (0.0%)0 (0.0%)
    1st preoperative KPS100.0 (90.0–100.0)92.5 (80.0–100.0)100.0 (90.0–100.0).41
    2nd preoperative KPS90.0 (80.0–100.0)90.0 (70.0–100.0)100.0 (90.0–100.0).39
    Postoperative treatment after 1st operation.42
        CCRT/TMZ11 (84.6%)17 (94.5%)8 (88.9%)
        Hypo-CCRT/TMZ2 (15.4%)0 (0.0%)0 (0.0%)
        Hypo-CCRT0 (0.0%)1 (5.6%)1 (11.1%)
    Radiation dose (Gy)61.0 (61.0–61.0)61.0 (61.0–61.0)61.0 (61.0–61.0).69
    • Note:—KPS indicates Karnofsky Performance Status.

    • ↵a Data are number of patients, means [2 SDs] for normally distributed variables, or medians (interquartile ranges) for nonnormally distributed variables.

    • ↵b P values were calculated using the Kruskal-Wallis test for nonparametric variables and the 1-way ANOVA for parametric variables.

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    Table 2:

    Diagnostic performance of the nrCBV values for discriminating unchanged MGMT methylation status (group MM) from changed MGMT methylation status (group MU) on the basis of the NER of the initial tumor

    VariableAUCSensitivity (%)Specificity (%)CutoffStandard Error95% CIP
    Initial tumor
        nrCBV mean0.88977.7892.31>2.5940.0730.682–0.982<.0001
        nrCBV 90P0.84688.8976.92>4.1590.0910.630–0.963.0001
        nrCBV 95P0.85566.6792.31>6.7940.0820.640–0.967<.0001
    • Note:—90P indicates 90th percentile; 95P, 95th percentile; AUC, area under the curve.

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American Journal of Neuroradiology: 42 (5)
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H.J. Choi, S.H. Choi, S.-H. You, R.-E. Yoo, K.M. Kang, T.J. Yun, J.-h. Kim, C.-H. Sohn, C.-K. Park, S.-H. Park
MGMT Promoter Methylation Status in Initial and Recurrent Glioblastoma: Correlation Study with DWI and DSC PWI Features
American Journal of Neuroradiology May 2021, 42 (5) 853-860; DOI: 10.3174/ajnr.A7004

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MGMT Promoter Methylation Status in Initial and Recurrent Glioblastoma: Correlation Study with DWI and DSC PWI Features
H.J. Choi, S.H. Choi, S.-H. You, R.-E. Yoo, K.M. Kang, T.J. Yun, J.-h. Kim, C.-H. Sohn, C.-K. Park, S.-H. Park
American Journal of Neuroradiology May 2021, 42 (5) 853-860; DOI: 10.3174/ajnr.A7004
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