Using MRI texture analysis and cerebrospinal DNA fluid in glioblastoma for preoperative molecular diagnostics

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K18405
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 56010:Neurosurgery-related
• Research Institution: Keio University
• Principal Investigator: Sasao Ryota 慶應義塾大学, 医学部(信濃町), 助教 (60837201)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 膠芽腫 / MRIテクスチャー解析 / 髄液DNA / 術前分子診断

Outline of Final Research Achievements

In the analysis by Mazda, it was predictable with a positive predictive value of 90% and a sensitivity of 42.9% when the diffusion weighted image Horzl_Fraction and 135dr_shrtREMp were used together. In the analysis by SYNAPSE VINCENT, it was possible to predict with a positive predictive value of 81.2% and a sensitivity of 61.9% by using the mean ADC value of Appearent diffusion coefficiennt and the ADC entrophy together. Molecular diagnosis of glioma by liquid biopsy was difficult to collect by lumbar puncture from the ethical point of view, and it was not possible to secure sufficient appropriate cases.

Free Research Field

脳腫瘍

Academic Significance and Societal Importance of the Research Achievements

MGMTメチル化の有無は、膠芽腫をはじめ神経膠腫のアルキル化剤反応性に深く関与しており、特にGrade 3以上の悪性神経膠腫では、術中（摘出後）にBCNU wafer（手術摘出腔留置用のアルキル化剤徐放剤）を留置するかどうかの判断材料となる。BCNU waferは、感染や炎症などの有害事象の原因となることもあり、術前にその効果が予測できれば、不要なリスクを避けることができる（効率的留置）。現状では術前にMGMTメチル化の有無を判断することは困難であり、神経膠腫の分子診断が術前に高い精度で可能となれば、不要な侵襲をなくすことができ、画期的な変革になると予想される。