title: Cerebral blood volume calculated by dynamic susceptibility contrast-enhanced perfusion MR imaging: preliminary correlation study with glioblastoma genetic profiles.
abstract: OBJECTIVE
  To evaluate the usefulness of dynamic susceptibility contrast (DSC) enhanced perfusion MR imaging in predicting major genetic alterations in glioblastomas.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors: Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
authors: Inseon
authors: I
authors: Ryoo
authors: Seung Hong
authors: SH
authors: Choi
authors: Ji-Hoon
authors: JH
authors: Kim
authors: Chul-Ho
authors: CH
authors: Sohn
authors: Soo Chin
authors: SC
authors: Kim
authors: Hwa Seon
authors: HS
authors: Shin
authors: Jeong A
authors: JA
authors: Yeom
authors: Seung Chai
authors: SC
authors: Jung
authors: A Leum
authors: AL
authors: Lee
authors: Tae Jin
authors: TJ
authors: Yun
authors: Chul-Kee
authors: CK
authors: Park
authors: Sung-Hye
authors: SH
authors: Park
mesh_terms: D001810:Blood Volume / Q000502:physiology*; D001932:Brain Neoplasms / Q000098:blood supply / Q000235:genetics / Q000473:pathology / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D016000:Cluster Analysis; D003287:Contrast Media; D019175:DNA Methylation / Q000235:genetics; D066246:ErbB Receptors / Q000235:genetics / Q000378:metabolism; D005260:Female; D005909:Glioblastoma / Q000098:blood supply / Q000235:genetics* / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019853:O(6)-Methylguanine-DNA Methyltransferase / Q000235:genetics; D051059:PTEN Phosphohydrolase / Q000235:genetics / Q000378:metabolism; D010477:Perfusion; D011401:Promoter Regions, Genetic / Q000235:genetics; D012044:Regression Analysis; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
chemical_list: D003287:Contrast Media; D016159:Tumor Suppressor Protein p53; D019853:O(6)-Methylguanine-DNA Methyltransferase; D066246:ErbB Receptors; D051059:PTEN Phosphohydrolase; C494929:PTEN protein, human
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