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Preoperative assessment of MGMT gene promoter methylation status in adult high-grade glioma patients by integrated 18F-FET PET/MR
HAN Qingqing  LI Tuo  LIN Zengping  LI Enhui  YANG Yang  LIU Jiahui  XING Hao  WANG Yu  CHENG Xin  HUO Li 

Cite this article as: HAN Q Q, LI T, LIN Z P, et al. Preoperative assessment of MGMT gene promoter methylation status in adult high-grade glioma patients by integrated 18F-FET PET/MR[J]. Chin J Magn Reson Imaging, 2024, 15(7): 21-26. DOI:10.12015/issn.1674-8034.2024.07.004.


[Abstract] Objective To investigate the discriminative ability of integrated 18F-fluoroethyltyrosine (18F-FET) positron emission tomography (PET)/MR for O6-methylguanine DNA methyltransferase (MGMT) gene promoter methylation status in adult gliomas.Materials and Methods A total of 16 patients with unbiopsied or untreated gliomas were retrospectively enrolled to complete integrated PET/MR scans, including 18F-FET PET, conventional MRI and intravoxel incoherent motion (IVIM) imaging. The volume of interest (VOI) segmentation of PET images was performed using target-background ratio (TBR)=1.6 as a threshold, and IVIM maps corresponding to tumor VOI and their parameters, apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo diffusion coefficient (D*), perfusion fraction (f), distributed diffusion coefficient (DDC), and heterogeneity index (α), were obtained by rigid alignment, and the corresponding first-order gray-scale histogram features were obtained by feature extraction of each parameter using pyradiomics. The eigenvalues corresponding to each IVIM parameter map were calculated in relation to the 18F-FET PET parameters, and the ability of PET and IVIM parameters to discriminate MGMT promoter methylation was explored using between-group comparisons and receiver operating characteristic (ROC) curve analysis.Results The two eigenvalues 90th percentile (r=0.526, P<0.05) and maximum (r=0.520, P<0.05) of IVIM-α were positively correlated with mean standard uptake value (SUVmean) of PET parameter; The differences between IVIM-α and SUVmean in the two groups of positive and negative MGMT promoter methylation status were statistically significant (P<0.05), and the positive group had significantly higher mean IVIM-α and SUVmean than the negative group. The area under the curve (AUC) of discrimination of the methylation status of the MGMT promoter by incorporating the mean IVIM-α value and SUVmean was 0.77.Conclusions 18F-FET PET and IVIM parameters based on integrated PET/MR can effectively predict MGMT promoter methylation status in gliomas.
[Keywords] glioma；O6-methylguanine DNA methyltransferase gene；18F-Fluoroethyltyrosine positron emission tomography (18F-FET PET)；positron emission tomography/magnetic resonance (PET/MR)；intravoxel incoherent motion；magnetic resonance imaging

HAN Qingqing1   LI Tuo1   LIN Zengping2   LI Enhui3   YANG Yang3   LIU Jiahui4   XING Hao4   WANG Yu4   CHENG Xin1   HUO Li1, 5*  

1 Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China

2 Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai 201807, China

3 Beijing United Imaging Research Institute of Intelligent Imaging, Beijing 100094, China

4 Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China

5 Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing 100730, China

Corresponding author: HUO L, E-mail: huoli@pumch.cn

Conflicts of interest   None.

Received  2024-02-27
Accepted  2024-07-08
DOI: 10.12015/issn.1674-8034.2024.07.004
Cite this article as: HAN Q Q, LI T, LIN Z P, et al. Preoperative assessment of MGMT gene promoter methylation status in adult high-grade glioma patients by integrated 18F-FET PET/MR[J]. Chin J Magn Reson Imaging, 2024, 15(7): 21-26. DOI:10.12015/issn.1674-8034.2024.07.004.

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