Glioblastoma radiomics: can genomic and molecular characteristics correlate with imaging response patterns?
Glioblastoma; Imaging response; Pseudoprogression; Radiomics; TCGA subtype; Aged; Brain Neoplasms/diagnostic imaging; Brain Neoplasms/genetics; Brain Neoplasms/therapy; Disease Progression; Female; Genomics; Glioblastoma/diagnostic imaging; Glioblastoma/genetics; Glioblastoma/therapy; Humans; Male; Middle Aged; Prognosis; Survival Rate
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.
Soike, Michael H; McTyre, Emory R; Shah, Nameeta; Puchalski, Ralph B; Holmes, Jordan A; Paulsson, Anna K; Miller, Lance D; Cramer, Christina K; Lesser, Glenn J; Strowd, Roy E; Hinson, William H; Mott, Ryan T; Johnson, Annette J; Lo, Hui-Wen; Laxton, Adrian W; Tatter, Stephen B; Debinski, Waldemar; and Chan, Michael D, "Glioblastoma radiomics: can genomic and molecular characteristics correlate with imaging response patterns?" (2018). Articles, Abstracts, and Reports. 627.