Diffusion-Weighted MR Imaging and MGMT Methylation Status in Glioblastoma: A Reappraisal of the Role of Preoperative Quantitative ADC Measurements

2052 Background: MGMT methylation status has been found to be an important prognostic factor in glioblastoma patients (pts). However, further data on the epigenetic feature are needed before its role in rare diseases such as anaplastic astrocytomas (AA) can be established. Methods: A retrospective analysis was made on a database of 139 AA pts followed prospectively from January 1995 and August 2008. We evaluated only pts who met the following inclusion criteria: age >18 years; PS 0–2; histological diagnosis of AA; postoperative radiotherapy (RT) and chemotherapy (CT). MGMT status was determined with methylation specific PCR. The study aim was to evaluate the role of MGMT methylation status in AA. The log-rank test was employed to evaluate the significance of the prognostic variables. Results: 80 pts (m/f: 46/34, median age: 41 years, range: 18–71 years) were enrolled. MGMT was assessable in 71 of 80 pts (88.8%), being methylated in 30 (42.9%), and unmethylated in 41 (57.7%) pts. Median PFS was 48.6 months (95% CI: 33.7 - 63.5), being 96 months (95% CI: 29–163) and 38 months (95%CI: 18.9–57.2) in MGMT methylated and unmethylated pts, respectively (p = 0.09). At univariate analysis, complete resection (p = 0.02), age (p = 0.002), and KPS (p = 0.003) were significantly correlated with PFS. At multivariate analysis only age remains correlated with PFS (p = 0.01). Median survival (OS) was 93.7 months (95% CI: 63.5–123.8), being not reached and 77 months (95% CI: 20–134.2), in MGMT methylated and unmethylated pts, respectively (p = 0.03). MGMT methylation (p = 0.03), age (p = 0.0003), and KPS (p = 0.03) were significantly correlated with OS at univariate analysis. At multivariate analysis, age (p = 0.0002) and MGMT methylation (p = 0.01) were correlated with a better OS. Conclusions: MGMT methylation status is an independent prognostic factor together with age in AA. This datum should provide the background to improve the therapeutic index with temozolomide concurrent with and adjuvant to RT in AA. No significant financial relationships to disclose.

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The role of diffusion weighted echo planar MR imaging in central nervous system infections associated with etiopathogenesis of the illness

Diagnostic and Interventional Radiology ◽

10.4261/1305-3825.dir.2564-09.1 ◽

2009 ◽

Cited By ~ 1

Author(s):

Yilmaz Kiroglu ◽

Nevzat Karabulut ◽

Alpay Alkan

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Mr Imaging ◽

Central Nervous System Infections ◽

Diffusion Weighted ◽

Echo Planar

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Role of diffusion-weighted MR imaging in differentiation between malignant and benign portal vein thrombosis in patients with Hepatocellular carcinoma

QJM ◽

10.1093/qjmed/hcab106.014 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ahmed Mohamed Hussien ◽

Allam El Sayed Allam ◽

Amr Mohamed Kamal Moharram

Keyword(s):

Retrospective Study ◽

Mr Imaging ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Daily Routine ◽

Reference Standard ◽

Vein Thrombosis ◽

Diffusion Weighted ◽

Contrast Enhanced

Abstract Background Differentiation between malignant and bland thrombus of the portal vein in patients who have HCC using diffusion weighted MR imaging. Objective To determine the role of DW imaging in differentiating between the benign and malignant portal vein thrombosis in patient with HCC. Patients and Methods This is a retrospective study done in ain-shams hospitals and private centers. This is a retrospective study done in Ain-Shams Hospitals and private centers. We studied 20 cases, 13 males and 7 females with total mean age 59.5. Results Our study had some limitations. First, we did not use pathologic findings as our reference standard for characterizing the thrombi; instead, we have used accepted imaging criteria as a reference standard. In our study, we used oval ROI placement and although we avoided averaging ADC of the thrombus with the surrounding structures “by enlarging the images and placing the ROI within the thrombus “, we cannot completely exclude that some averaging could have occurred in the smallest thrombi. Conclusion In addition to the initial diagnosis of the PVT nature, subsequent contrast-enhanced MRI is actually necessary to evaluate further treatment response in daily routine. But the administration of I.V. contrast agent is problematic especially in patients with renal insufficiency. Therefore, DWI technique can be utilized in adjunction with routine MRI protocols to determine the nature of PVTs by the calculation of ADCs values.

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