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European Radiology

, Volume 23, Issue 2, pp 513–520 | Cite as

Apparent diffusion coefficient obtained by magnetic resonance imaging as a prognostic marker in glioblastomas: correlation with MGMT promoter methylation status

  • Andrea RomanoEmail author
  • L. F. Calabria
  • F. Tavanti
  • G. Minniti
  • M. C. Rossi-Espagnet
  • V. Coppola
  • S. Pugliese
  • D. Guida
  • G. Francione
  • C. Colonnese
  • L. M. Fantozzi
  • A. Bozzao
Neuro

Abstract

Objective

To evaluate whether apparent diffusion coefficient (ADC) values can predict the status of MGMT of glioblastoma multiforme (GBM) and correlate with overall survival (OS) and progression-free survival (PFS).

Methods

This retrospective study included 47 patients with pathologically proven glioblastoma. All of them underwent MR DWI study before surgery (mean time 1 week) and the status of methylguanine-DNA-methyltransferase (MGMT) promoter methylation was searched for. Minimum apparent diffusion coefficient (ADC) values were evaluated. OS and PSF parameters were calculated, and Student’s t-test, Kaplan-Meier curves, linear and Cox regression were performed.

Results

Twenty-five patients showed positive methylation of the MGMT promoter. Patients showing MGMT promoter methylation had higher minimum ADC values, and they survived longer than those without MGMT promoter methylation. The median ADCmin value of 0.80 represents the cutoff value able to distinguish between methylated and un-methylated patients. Patients showing minimum ADC values higher than 0.80 survived longer than patients with minimum ADC values lower than 0.80. A linear correlation between minimum ADC values vs. the OS and PFS was observed.

Conclusions

Minimum ADC values in glioblastoma multiforme could be used as a preoperative parameter to estimate the status of MGMT promoter methylation and the survival of patients.

Key Points

• Diffusion-weighted MR imaging (DWI) provides new insights into glioblastoma multiforme (GBM)

• DWI ADCmin values can predict the methylation status of MGMT promoter.

• The MGMT promoter methylation group survived longer than the unmethylated group.

• Patients with high ADCmin values survived longer than patients with low values.

Keywords

Methylation status of MGMT promoter Apparent diffusion coefficient Overall survival Progression-free survival Glioblastoma multiforme 

Abbreviations

RT

Radiotherapy

MGMT

Methylguanine-DNA-methyltransferase

PFS

Progression-free survival

OS

Overall survival

ADC

Apparent diffusion coefficient

DWI

Diffusion-weighted images

GBM

Glioblastoma multiforme

TMZ

Temozolomide

MPRAGE

Magnetisation-prepared rapid acquisition gradient echo

ROC

Received operating characteristic

ROI

Region of interest

FLAIR

Fluid attenuated inversion recovery

PCR

Polymerase chain reaction

FA

Fractional anisotropy

Notes

Acknowledgement

Beatrice Bozzao, English editing.

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Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Andrea Romano
    • 1
    • 2
    • 6
    Email author
  • L. F. Calabria
    • 1
  • F. Tavanti
    • 1
  • G. Minniti
    • 3
  • M. C. Rossi-Espagnet
    • 1
  • V. Coppola
    • 1
  • S. Pugliese
    • 1
  • D. Guida
    • 1
  • G. Francione
    • 1
  • C. Colonnese
    • 4
    • 5
  • L. M. Fantozzi
    • 1
  • A. Bozzao
    • 1
  1. 1.NESMOS, Department of Neuroradiology, S. Andrea HospitalUniversity SapienzaRomeItaly
  2. 2.IRCSS San Raffaele PisanaRomeItaly
  3. 3.Department of Radiotherapy, S. Andrea HospitalUniversity SapienzaRomeItaly
  4. 4.Department of Neuroradiology, IRCSS NeuromedUniversity SapienzaPozzilliItaly
  5. 5.Department of Neuroradiology, Umberto I HospitalUniversity SapienzaRomeItaly
  6. 6.RomeItaly

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