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<meta name="DC.Title" content="Clinically Relevant Imaging Features for MGMT Promoter Methylation in Multiple Glioblastoma Studies: A Systematic Review and Meta-Analysis" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5711" />
<meta name="DC.Date" content="2018-08-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND: O6-methylguanine methyltransferase ( MGMT ) promoter methylation status has been reported as a prognostic biomarker in clinical trials.

PURPOSE: Our aim was to systematically evaluate imaging features of MGMT promoter methylated glioblastoma and to determine the diagnostic performance of MR imaging for prediction of MGMT promoter methylation in patients with newly diagnosed glioblastoma.

DATA SOURCES: A computerized search of Ovid MEDLINE and EMBASE up to February 27, 2018, was conducted.

STUDY SELECTION: We selected studies evaluating imaging features of MGMT promoter methylated glioblastoma and the diagnostic performance of MR imaging for prediction of MGMT promoter methylation.

DATA ANALYSIS: Pooled estimates of sensitivity and specificity were calculated using a hierarchic logistic regression model. Meta-regression and sensitivity analysis were performed.

DATA SYNTHESIS: Twenty-two articles including 2199 patients were included. MGMT promoter methylated glioblastoma is likely to show less edema, high ADC, and low perfusion. Ten articles including 753 patients were included in the meta-analysis. The summary sensitivity was 79% (95% CI, 72%–85%), and the summary specificity was 78% (95% CI, 71%–84%). In the meta-regression, MGMT promoter methylation and mean age were associated with heterogeneity. Sensitivity analysis excluding 1 study resolved the heterogeneity.

LIMITATIONS: Included studies used a variety of different MR imaging techniques to predict MGMT promoter methylation.

CONCLUSIONS: MGMT promotor methylated glioblastoma is likely to show less aggressive imaging features than MGMT promotor unmethylated glioblastoma. Despite the variety of different MR imaging techniques used, MR imaging in patients with newly diagnosed glioblastoma was shown to have the potential to predict MGMT promoter methylation noninvasively.

DCE
:   dynamic contrast-enhanced imaging
HSROC
:   hierarchic summary receiver operating characteristic
IDH 
:   isocitrate dehydrogenase 
MGMT 
:   O6-methylguanine methyltransferase 
PRISMA
:   Preferred Reporting Items for Systematic Reviews and Meta-Analyses
QUADAS-2
:   Quality Assessment of Diagnostic Accuracy Studies-2
WHO
:   World Health Organization" />
<meta name="DC.Contributor" content="C.H. Suh" />
<meta name="DC.Contributor" content="H.S. Kim" />
<meta name="DC.Contributor" content="S.C. Jung" />
<meta name="DC.Contributor" content="C.G. Choi" />
<meta name="DC.Contributor" content="S.J. Kim" />
<meta name="article:published_time" content="2018-08-01" />
<meta name="article:section" content="Adult Brain" />
<meta name="citation_title" content="Clinically Relevant Imaging Features for MGMT Promoter Methylation in Multiple Glioblastoma Studies: A Systematic Review and Meta-Analysis" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND:&lt;/h3&gt;
&lt;p&gt;&lt;i&gt;O6-methylguanine methyltransferase&lt;/i&gt; (&lt;i&gt;MGMT&lt;/i&gt;) promoter methylation status has been reported as a prognostic biomarker in clinical trials.&lt;/p&gt;&lt;h3&gt;PURPOSE:&lt;/h3&gt;
&lt;p&gt;Our aim was to systematically evaluate imaging features of &lt;i&gt;MGMT&lt;/i&gt; promoter methylated glioblastoma and to determine the diagnostic performance of MR imaging for prediction of &lt;i&gt;MGMT&lt;/i&gt; promoter methylation in patients with newly diagnosed glioblastoma.&lt;/p&gt;&lt;h3&gt;DATA SOURCES:&lt;/h3&gt;
&lt;p&gt;A computerized search of Ovid MEDLINE and EMBASE up to February 27, 2018, was conducted.&lt;/p&gt;&lt;h3&gt;STUDY SELECTION:&lt;/h3&gt;
&lt;p&gt;We selected studies evaluating imaging features of &lt;i&gt;MGMT&lt;/i&gt; promoter methylated glioblastoma and the diagnostic performance of MR imaging for prediction of &lt;i&gt;MGMT&lt;/i&gt; promoter methylation.&lt;/p&gt;&lt;h3&gt;DATA ANALYSIS:&lt;/h3&gt;
&lt;p&gt;Pooled estimates of sensitivity and specificity were calculated using a hierarchic logistic regression model. Meta-regression and sensitivity analysis were performed.&lt;/p&gt;&lt;h3&gt;DATA SYNTHESIS:&lt;/h3&gt;
&lt;p&gt;Twenty-two articles including 2199 patients were included. &lt;i&gt;MGMT&lt;/i&gt; promoter methylated glioblastoma is likely to show less edema, high ADC, and low perfusion. Ten articles including 753 patients were included in the meta-analysis. The summary sensitivity was 79% (95% CI, 72%–85%), and the summary specificity was 78% (95% CI, 71%–84%). In the meta-regression, &lt;i&gt;MGMT&lt;/i&gt; promoter methylation and mean age were associated with heterogeneity. Sensitivity analysis excluding 1 study resolved the heterogeneity.&lt;/p&gt;&lt;h3&gt;LIMITATIONS:&lt;/h3&gt;
&lt;p&gt;Included studies used a variety of different MR imaging techniques to predict &lt;i&gt;MGMT&lt;/i&gt; promoter methylation.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;&lt;i&gt;MGMT&lt;/i&gt; promotor methylated glioblastoma is likely to show less aggressive imaging features than &lt;i&gt;MGMT&lt;/i&gt; promotor unmethylated glioblastoma. Despite the variety of different MR imaging techniques used, MR imaging in patients with newly diagnosed glioblastoma was shown to have the potential to predict &lt;i&gt;MGMT&lt;/i&gt; promoter methylation noninvasively.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2018/08/01" />
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<meta name="citation_author" content="C.H. Suh" />
<meta name="citation_author_institution" content="aFrom the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea." />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-4737-0530" />
<meta name="citation_author" content="H.S. Kim" />
<meta name="citation_author_institution" content="aFrom the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea." />
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<meta name="citation_author" content="S.J. Kim" />
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<meta name="twitter:title" content="Clinically Relevant Imaging Features for MGMT Promoter Methylation in Multiple Glioblastoma Studies: A Systematic Review and Meta-Analysis" />
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<meta name="twitter:description" content="BACKGROUND: O6-methylguanine methyltransferase ( MGMT ) promoter methylation status has been reported as a prognostic biomarker in clinical trials.

PURPOSE: Our aim was to systematically evaluate imaging features of MGMT promoter methylated glioblastoma and to determine the diagnostic performance of MR imaging for prediction of MGMT promoter methylation in patients with newly diagnosed glioblastoma.

DATA SOURCES: A computerized search of Ovid MEDLINE and EMBASE up to February 27, 2018, was conducted.

STUDY SELECTION: We selected studies evaluating imaging features of MGMT promoter methylated glioblastoma and the diagnostic performance of MR imaging for prediction of MGMT promoter methylation.

DATA ANALYSIS: Pooled estimates of sensitivity and specificity were calculated using a hierarchic logistic regression model. Meta-regression and sensitivity analysis were performed.

DATA SYNTHESIS: Twenty-two articles including 2199 patients were included. MGMT promoter methylated glioblastoma is likely to show less edema, high ADC, and low perfusion. Ten articles including 753 patients were included in the meta-analysis. The summary sensitivity was 79% (95% CI, 72%–85%), and the summary specificity was 78% (95% CI, 71%–84%). In the meta-regression, MGMT promoter methylation and mean age were associated with heterogeneity. Sensitivity analysis excluding 1 study resolved the heterogeneity.

LIMITATIONS: Included studies used a variety of different MR imaging techniques to predict MGMT promoter methylation.

CONCLUSIONS: MGMT promotor methylated glioblastoma is likely to show less aggressive imaging features than MGMT promotor unmethylated glioblastoma. Despite the variety of different MR imaging techniques used, MR imaging in patients with newly diagnosed glioblastoma was shown to have the potential to predict MGMT promoter methylation noninvasively.

DCE
:   dynamic contrast-enhanced imaging
HSROC
:   hierarchic summary receiver operating characteristic
IDH 
:   isocitrate dehydrogenase 
MGMT 
:   O6-methylguanine methyltransferase 
PRISMA
:   Preferred Reporting Items for Systematic Reviews and Meta-Analyses
QUADAS-2
:   Quality Assessment of Diagnostic Accuracy Studies-2
WHO
:   World Health Organization" />
<meta name="og-title" property="og:title" content="Clinically Relevant Imaging Features for MGMT Promoter Methylation in Multiple Glioblastoma Studies: A Systematic Review and Meta-Analysis" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/39/8/1439" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND: O6-methylguanine methyltransferase ( MGMT ) promoter methylation status has been reported as a prognostic biomarker in clinical trials.

PURPOSE: Our aim was to systematically evaluate imaging features of MGMT promoter methylated glioblastoma and to determine the diagnostic performance of MR imaging for prediction of MGMT promoter methylation in patients with newly diagnosed glioblastoma.

DATA SOURCES: A computerized search of Ovid MEDLINE and EMBASE up to February 27, 2018, was conducted.

STUDY SELECTION: We selected studies evaluating imaging features of MGMT promoter methylated glioblastoma and the diagnostic performance of MR imaging for prediction of MGMT promoter methylation.

DATA ANALYSIS: Pooled estimates of sensitivity and specificity were calculated using a hierarchic logistic regression model. Meta-regression and sensitivity analysis were performed.

DATA SYNTHESIS: Twenty-two articles including 2199 patients were included. MGMT promoter methylated glioblastoma is likely to show less edema, high ADC, and low perfusion. Ten articles including 753 patients were included in the meta-analysis. The summary sensitivity was 79% (95% CI, 72%–85%), and the summary specificity was 78% (95% CI, 71%–84%). In the meta-regression, MGMT promoter methylation and mean age were associated with heterogeneity. Sensitivity analysis excluding 1 study resolved the heterogeneity.

LIMITATIONS: Included studies used a variety of different MR imaging techniques to predict MGMT promoter methylation.

CONCLUSIONS: MGMT promotor methylated glioblastoma is likely to show less aggressive imaging features than MGMT promotor unmethylated glioblastoma. Despite the variety of different MR imaging techniques used, MR imaging in patients with newly diagnosed glioblastoma was shown to have the potential to predict MGMT promoter methylation noninvasively.

DCE
:   dynamic contrast-enhanced imaging
HSROC
:   hierarchic summary receiver operating characteristic
IDH 
:   isocitrate dehydrogenase 
MGMT 
:   O6-methylguanine methyltransferase 
PRISMA
:   Preferred Reporting Items for Systematic Reviews and Meta-Analyses
QUADAS-2
:   Quality Assessment of Diagnostic Accuracy Studies-2
WHO
:   World Health Organization" />
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    <title>Clinically Relevant Imaging Features for MGMT Promoter Methylation in Multiple Glioblastoma Studies: A Systematic Review and Meta-Analysis | American Journal of Neuroradiology</title>  
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node62151--5" data-node-nid="62151" id="top-node-62151--61779142430" data-pisa="ajnr;39/8/1439" data-pisa-master="ajnr;ajnr.A5711" data-apath="/ajnr/39/8/1439.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
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      <h1 class="highwire-cite-title" id="page-title">Clinically Relevant Imaging Features for <em>MGMT</em> Promoter Methylation in Multiple Glioblastoma Studies: A Systematic Review and Meta-Analysis</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">C.H. Suh</span>, <span class="highwire-citation-author" data-delta="1">H.S. Kim</span>, <span class="highwire-citation-author" data-delta="2">S.C. Jung</span>, <span class="highwire-citation-author" data-delta="3">C.G. Choi</span> and <span class="highwire-citation-author" data-delta="4">S.J. Kim</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">August 2018,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1439-1445; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5711 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-62151--61779142430" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">C.H. Suh </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.H.%2BSuh%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Suh%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.H.%2BSuh%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4737-0530" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C.H. Suh</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">H.S. Kim </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.S.%2BKim%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kim%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.S.%2BKim%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-9477-7421" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H.S. Kim</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">S.C. Jung </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.C.%2BJung%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Jung%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.C.%2BJung%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-5559-7973" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.C. Jung</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">C.G. Choi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.G.%2BChoi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Choi%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.G.%2BChoi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-2251-1915" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C.G. Choi</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">S.J. Kim </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.J.%2BKim%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kim%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.J.%2BKim%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7070-7333" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.J. 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      <div class="highwire-cite-title">Clinically Relevant Imaging Features for <em>MGMT</em> Promoter Methylation in Multiple Glioblastoma Studies: A Systematic Review and Meta-Analysis</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">C.H.</span> <span class="nlm-surname">Suh</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">H.S.</span> <span class="nlm-surname">Kim</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">S.C.</span> <span class="nlm-surname">Jung</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">C.G.</span> <span class="nlm-surname">Choi</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">S.J.</span> <span class="nlm-surname">Kim</span></span></span></div>
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">C.H.</span> <span class="nlm-surname">Suh</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">H.S.</span> <span class="nlm-surname">Kim</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">S.C.</span> <span class="nlm-surname">Jung</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">C.G.</span> <span class="nlm-surname">Choi</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">S.J.</span> <span class="nlm-surname">Kim</span></span></span></div>
  
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