Assessment of MGMT promoter methylation status in glioblastoma using deep learning features from multi-sequence MRI of intratumoral and peritumoral regions.

Objective: This study aims to evaluate the effectiveness of deep learning features derived from multi-sequence magnetic resonance imaging (MRI) in determining the O-methylguanine-DNA methyltransferase (MGMT) promoter methylation status among glioblastoma patients.

Methods: Clinical, pathological, and MRI data of 356 glioblastoma patients (251 methylated, 105 unmethylated) were retrospectively examined from the public dataset The Cancer Imaging Archive. Each patient underwent preoperative multi-sequence brain MRI scans, which included T1-weighted imaging (T1WI) and contrast-enhanced T1-weighted imaging (CE-T1WI). Regions of interest (ROIs) were delineated to identify the necrotic tumor core (NCR), enhancing tumor (ET), and peritumoral edema (PED). The ET and NCR regions were categorized as intratumoral ROIs, whereas the PED region was categorized as peritumoral ROIs. Predictive models were developed using the Transformer algorithm based on intratumoral, peritumoral, and combined MRI features. The area under the receiver operating characteristic curve (AUC) was employed to assess predictive performance.

Results: The ROI-based models of intratumoral and peritumoral regions, utilizing deep learning algorithms on multi-sequence MRI, were capable of predicting MGMT promoter methylation status in glioblastoma patients. The combined model of intratumoral and peritumoral regions exhibited superior diagnostic performance relative to individual models, achieving an AUC of 0.923 (95% confidence interval [CI]: 0.890 - 0.948) in stratified cross-validation, with sensitivity and specificity of 86.45% and 87.62%, respectively.

Conclusion: The deep learning model based on MRI data can effectively distinguish between glioblastoma patients with and without MGMT promoter methylation.