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Neuroradiology. 2018 Oct;60(10):1043-1051. doi: 10.1007/s00234-018-2060-y. Epub 2018 Aug 10.

Glioblastoma radiomics: can genomic and molecular characteristics correlate with imaging response patterns?

Author information

1
Department of Radiation Oncology, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA. msoike@wakehealth.edu.
2
Department of Radiation Oncology, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA.
3
The Ben and Catherine Ivy Center for Advanced Brain Tumor Treatment, Swedish Neuroscience Institute, Seattle, WA, 98122, USA.
4
Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC, 27514, USA.
5
Department of Radiation Oncology, University of California San Francisco School of Medicine, San Francisco, CA, 94143, USA.
6
Department of Cancer Biology, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA.
7
Brain Tumor Center of Excellence, Wake Forest Baptist Medical Center Comprehensive Cancer Center, Winston-Salem, NC, 27157, USA.
8
Department of Hematology & Oncology, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA.
9
Department of Neurology, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA.
10
Department of Pathology, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA.
11
Department of Radiology, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA.
12
Department of Neurosurgery, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA.

Abstract

PURPOSE:

For glioblastoma (GBM), imaging response (IR) or pseudoprogression (PSP) is frequently observed after chemoradiation and may connote a favorable prognosis. With tumors categorized by the Cancer Genome Atlas Project (mesenchymal, classical, neural, and proneural) and by methylguanine-methyltransferase (MGMT) methylation status, we attempted to determine if certain genomic or molecular subtypes of GBM were specifically associated with IR or PSP.

METHODS:

Patients with GBM treated at two institutions were reviewed. Kaplan-Meier method was used to estimate overall survival (OS) and progression-free survival (PFS). Mantel-cox test determined effect of IR and PSP on OS and PFS. Fisher's exact test was utilized to correlate IR and PSP with genomic subtypes and MGMT status.

RESULTS:

Eighty-two patients with GBM were reviewed. The median OS and PFS were 17.9 months and 8.9 months. IR was observed in 28 (40%) and was associated with improved OS (median 29.4 vs 14.5 months p < 0.01) and PFS (median 17.7 vs 5.5 months, p < 0.01). PSP was observed in 14 (19.2%) and trended towards improved PFS (15.0 vs 7.7 months p = 0.08). Tumors with a proneural component had a higher rate of IR compared to those without a proneural component (IR 60% vs 28%; p = 0.03). MGMT methylation was associated with IR (58% vs 24%, p = 0.032), but not PSP (34%, p = 0.10).

CONCLUSION:

IR is associated with improved OS and PFS. The proneural subtype and MGMT methylated tumors had higher rates of IR.

KEYWORDS:

Glioblastoma; Imaging response; Pseudoprogression; Radiomics; TCGA subtype

PMID:
30094640
DOI:
10.1007/s00234-018-2060-y
[Indexed for MEDLINE]

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