Histogram analysis of C-11-methionine integrated PET/MRI may facilitate to determine the O-6-methylguanylmethyltransferase methylation status in gliomas

Objective We evaluate the O-6-methylguanylmethyltransferase (MGMT) methylation status noninvasively by analyzing radiomics features of C-11-methionine (MET) PET images, which may reflect the detailed biological properties of gliomas. Patients and methods Fifty-seven patients with histopathologically confirmed gliomas, who were initially examined with C-11-MET PET/MR were retrospectively enrolled. Quantitative uptake of MET was assessed using conventional, histogram and texture features. These features were compared between the two groups classified by MGMT promoter methylation status. Results The histogram features (Skewness and Kurtosis) of the MGMT methylated group were significantly higher than those of the MGMT unmethylated group (Skewness: 0.90 +/- 0.71 vs. 0.49 +/- 0.45; P = 0.01) (Kurtosis: 1.36 +/- 2.30 vs. 0.08 +/- 0.65; P = 0.003), but there were no significant differences in Skewness or Kurtosis between the groups in glioma-grade-matched subgroup analysis. Moreover, there was no significant difference in other features between the methylated group and unmethylated group. Conclusion The histogram features (Skewness and Kurtosis) of MET PET/MRI may be two key indicators to detect MGMT methylation status in gliomas and valuable predictors for the clinical responses of patients scheduled to receive temozolomide chemotherapeutics. Copyright (C) 2019 Wolters Kluwer Health, Inc. All rights reserved.