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• Clinical Articles •
Application of Sy-MRI combined with DWI in predicting MGMT methylation in glioma
MA Wenfu  GE Xin  DANG Pei  HUANG Xueying  LÜ Ruirui  ZHENG Jiarui  ZHANG Wei  WANG Xiaodong 

Cite this article as: MA W F, GE X, DANG P, et al. Application of Sy-MRI combined with DWI in predicting MGMT methylation in glioma[J]. Chin J Magn Reson Imaging, 2023, 14(7): 18-24, 48. DOI:10.12015/issn.1674-8034.2023.07.004.


[Abstract] Objective To investigate the value of synthetic MRI (Sy-MRI) combined with diffusion weighted imaging (DWI) in predicting the methylation status of O6-methylguanine DNA methyltransferase (MGMT) promoter in glioma.Materials and Methods Forty-seven patients with gliomas who underwent tumor resection in the General Hospital of Ningxia Medical University from October 2020 to December 2021 were prospectively collected. All patients were scanned by Sy-MRI and DWI sequence at the GE Architect 3.0 T superconducting MR scanner before operation. According to the pathological results of MGMT promoter methylation after the operation, they were divided into methylation group and non-methylation group. The pre-and post-enhanced Sy-MRI parameter maps (pre-T1, post-T1, pre-T2, post-T2, pre-PD and post-PD) were registered with the DWI-based apparent diffusion coefficient (ADC) map, and then the signal of the glioma parenchyma in the above parameter map was measured. The independent sample student's t-test or Mann-Whitney U test was used to compare the differences between the parameters of the methylation group and the non-methylation group of MGMT promoter. Receiver operating characteristic (ROC) curve was used to evaluate the efficacy of independent and combined diagnosis of MGMT promoter methylation, and the DeLong test was used to compare the difference of area under ROC curve (AUC).Results The values of post-T1, pre-T2, post-T2, and post-PD in the MGMT promoter methylation group were lower than those in the non-methylation group, with a statistically significant difference (P＜0.05). The values of pre-T1 and pre-PD had no statistically significant difference between the two groups (P＞0.05). The ADC values in the methylation group were lower than those in the non-methylation group, with a statistically significant difference (P＜0.05). Multivariate logistic regression analysis showed that pre-T2 [OR=1.031, 95% confidence interval (CI): 1.002-1.062, P=0.038], post-T1 (OR=1.003, 95% CI: 1.001-1.007, P=0.015) and ADC (OR=1.041, 95% CI: 1.008-1.072, P=0.047) values were independent factors for predicting MGMT methylation in gliomas. The results of ROC curve analysis showed that the AUC values of pre-T2, post-T1 and ADC for independent diagnosis of MGMT promoter methylation were 0.722, 0.808 and 0.685 respectively, and the AUC of MGMT promoter methylation diagnosed by the combined model of the above three parameters was 0.815. The results of the DeLong test showed that the diagnostic efficacy of the combined parameter model was higher than that of the ADC value, and the difference was statistically significant (P=0.03). There was no significant difference between pre-T2, post-T1 and the AUC value of the combined parameter model (P＞0.05).Conclusions Sy-MRI can well diagnose the methylation of the MGMT promoter in gliomas, and the diagnostic efficiency is significantly higher than that of traditional DWI. The diagnostic efficiency is higher when the Sy-MRI parameter is combined with the ADC value of DWI.
[Keywords] glioma；magnetic resonance imaging；synthetic magnetic resonance imaging；diffusion weighted imaging；O6-methylguanine DNA methyltransferase；methylation；predict；diagnosis

MA Wenfu1   GE Xin2   DANG Pei3   HUANG Xueying3   LÜ Ruirui1   ZHENG Jiarui1   ZHANG Wei3   WANG Xiaodong3*  

1 Clinical Medical College, Ningxia Medical University, Yinchuan 750004, China

2 The Second Clinical Medical College of Lanzhou University, Lanzhou 730030, China

3 Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750004, China

Corresponding author: Wang XD, E-mail: xdw80@yeah.net

Conflicts of interest   None.

ACKNOWLEDGMENTS Natural Science Foundation of Ningxia Hui Autonomous Region (No. 2023AAC03557); Scientific Research Project of Health System of Ningxia Hui Autonomous Region (No. 2023-NWKYP-046).
Received  2022-12-20
Accepted  2023-06-25
DOI: 10.12015/issn.1674-8034.2023.07.004
Cite this article as: MA W F, GE X, DANG P, et al. Application of Sy-MRI combined with DWI in predicting MGMT methylation in glioma[J]. Chin J Magn Reson Imaging, 2023, 14(7): 18-24, 48. DOI:10.12015/issn.1674-8034.2023.07.004.

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