Dynamic Contrast-Enhanced Magnetic Resonance Imaging-Derived kep as a Potential Biomarker of Matrix Metalloproteinase 9 Expression in Patients With Glioblastoma Multiforme: A Pilot Study

Objective: To look for the association of tissue matrix metalloproteinase 9 (MMP-9) expression with dynamic contrast-enhanced magnetic resonance imaging and to see whether these can prognosticate patients with glioblastoma multiforme (GBM). Methods: Forty-seven patients with GBM underwent dynamic contrast-enhanced magnetic resonance imaging to look for association of its indices with tissue MMP-9 expression using Pearson correlation. Kaplan-Meier survival analysis was performed to study the survival pattern for low-, medium-, and high-tissue MMP-9 expression and k(ep) values. Results: Among perfusion indices, k(ep), k(trans), and v(e) significantly correlated with MMP-9 expression. Matrix metalloproteinase 9 expression was found to be best estimated by k(ep) using a quadratic model. The 1-year survival in low-, medium-, and high-tissue MMP-9 and k(ep) groups were 59%, 45%, and 7%, and 59%, 33%, and 15%, respectively. Conclusion: The association of k(ep) and MMP-9 expression with survival suggests that k(ep) may be used as imaging biomarker of GBM progression and its prognostication.