Progress of multimodality magnetic resonance techniques in predicting the MGMT promoter methylation status of glioma
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摘要: 胶质瘤是最常见的原发性中枢神经系统恶性肿瘤。O6-甲基鸟嘌呤-DNA甲基转移酶(MGMT)启动子甲基化是胶质瘤一个重要的分子特征,与烷化剂化疗敏感性、预后、风险分层、肿瘤复发等密切相关。当前仅使用手术标本通过基因检测分析来确定MGMT启动子甲基化状态,这一过程有局限性。MRI是目前应用最广泛的脑肿瘤非侵入性检查方法,近年来已有多种先进磁共振成像技术被用于术前无创性评估MGMT甲基化状态,这将有助于预测治疗反应和预后。本文就近几年化学交换饱和转移成像和酰胺质子转移成像、灌注加权成像(动态磁敏感对比增强成像、动态对比增强灌注成像、动脉自旋标记、基于流入的血管空间占位)、扩散成像(扩散张量成像、扩散峰度成像、体素内不相干运动、限制光谱成像)、磁敏感加权成像、波谱成像等磁共振成像技术预测MGMT甲基化状态的研究进展及MGMT甲基化临床意义进行综述,以期为患者个体化治疗方案的制定提供术前依据。
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关键词:
- 脑胶质瘤 /
- O6-甲基鸟嘌呤甲基转移酶 /
- 磁共振成像
Abstract: Gliomas are the most common primary central nervous system malignancy. O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation is an important molecular feature of glioma, which is closely related to alkylating agent chemotherapy sensitivity, prognosis, risk stratification, and tumor recurrence. Currently, only surgical specimens are used for genetic testing analysis to determine the methylation status of MGMT promoters, but this process has limitations. MRI is currently the most widely used non-invasive examination method for brain tumors. In recent years, a number of advanced magnetic resonance imaging techniques have been used to assess MGMT methylation status non-invasively before surgery, which will help predict treatment response and prognosis. The paper reviewed the research progress of magnetic resonance imaging techniques to predict the methylation status of MGMT including chemical exchange saturation transfer imaging and amide proton transfer imaging, perfusion-weighted imaging (dynamic susceptibility contrast, dynamic contrast enhance, arterial spine labeling, and inflow-based vascular-space-occupancy), diffusion imaging (diffusion tensor imaging, diffusion kurtosis imaging, intravoxel incoherent motion, restriction spectrum imaging), susceptibility weighted imaging, magnetic resonance spectroscopy imaging and the clinical significance of MGMT methylation. In order to provide a preoperative basis for the formulation of individualized treatment plans for patients. -
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