Cerebral blood volume calculated by dynamic susceptibility contrast-enhanced perfusion MR imaging: preliminary correlation study with glioblastoma genetic profiles

• Published in: PloS one 2013-08, Vol.8 (8), p.e71704-e71704
• Main Authors: Ryoo, Inseon, Choi, Seung Hong, Kim, Ji-Hoon, Sohn, Chul-Ho, Kim, Soo Chin, Shin, Hwa Seon, Yeom, Jeong A, Jung, Seung Chai, Lee, A Leum, Yun, Tae Jin, Park, Chul-Kee, Park, Sung-Hye
• Format: Article
• Language: English
• Subjects: Alterations; Antigens; Biology; Blood; Blood volume; Blood Volume - physiology; Brain cancer; Brain Neoplasms - blood supply; Brain Neoplasms - genetics; Brain Neoplasms - pathology; Brain Neoplasms - physiopathology; Cancer therapies; Cerebral blood flow; Cerebrovascular Circulation; Cluster Analysis; Contrast Media; Correlation; Correlation analysis; Deoxyribonucleic acid; DNA; DNA methylation; DNA Methylation - genetics; DNA methyltransferase; Epidermal growth factor; Epidermal growth factor receptors; Epidermal growth factors; Female; Gene expression; Glioblastoma; Glioblastoma - blood supply; Glioblastoma - genetics; Glioblastoma - pathology; Glioblastoma - physiopathology; Glioblastomas; Homology; Hospitals; Humans; Image segmentation; Immunohistochemistry; Magnetic Resonance Imaging; Male; Mathematical analysis; Medical prognosis; Medical research; Medicine; Methylation; Methylguanine; Middle Aged; NMR; Nuclear magnetic resonance; O-Methylguanine-DNA Methyltransferase - genetics; O6-methylguanine-DNA methyltransferase; p53 Protein; Patients; Perfusion; Phosphatases; Physicians; Promoter Regions, Genetic - genetics; PTEN Phosphohydrolase - genetics; PTEN Phosphohydrolase - metabolism; PTEN protein; Receptor, Epidermal Growth Factor - genetics; Receptor, Epidermal Growth Factor - metabolism; Regression Analysis; Segmentation; Statistical analysis; Surgery; Tensin; Tumor proteins; Tumor Suppressor Protein p53 - metabolism; Tumors
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0071704

To evaluate the usefulness of dynamic susceptibility contrast (DSC) enhanced perfusion MR imaging in predicting major genetic alterations in glioblastomas. Twenty-five patients (M:F = 13∶12, mean age: 52.1±15.2 years) with pathologically proven glioblastoma who underwent DSC MR imaging before surgery were included. On DSC MR imaging, the normalized relative tumor blood volume (nTBV) of the enhancing solid portion of each tumor was calculated by using dedicated software (Nordic TumorEX, NordicNeuroLab, Bergen, Norway) that enabled semi-automatic segmentation for each tumor. Five major glioblastoma genetic alterations (epidermal growth factor receptor (EGFR), phosphatase and tensin homologue (PTEN), Ki-67, O6-methylguanine-DNA methyltransferase (MGMT) and p53) were confirmed by immunohistochemistry and analyzed for correlation with the nTBV of each tumor. Statistical analysis was performed using the unpaired Student t test, ROC (receiver operating characteristic) curve analysis and Pearson correlation analysis. The nTBVs of the MGMT methylation-negative group (mean 9.5±7.5) were significantly higher than those of the MGMT methylation-positive group (mean 5.4±1.8) (p = .046). In the analysis of EGFR expression-positive group, the nTBVs of the subgroup with loss of PTEN gene expression (mean: 10.3±8.1) were also significantly higher than those of the subgroup without loss of PTEN gene expression (mean: 5.6±2.3) (p = .046). Ki-67 labeling index indicated significant positive correlation with the nTBV of the tumor (p = .01). We found that glioblastomas with aggressive genetic alterations tended to have a high nTBV in the present study. Thus, we believe that DSC-enhanced perfusion MR imaging could be helpful in predicting genetic alterations that are crucial in predicting the prognosis of and selecting tailored treatment for glioblastoma patients.