Deep learning MRI signature to predict survival and treatment benefit from temozolomide in IDH-wildtype glioblastoma

Abstract

BackgroundO6-methylguanine-DNA-methyltransferase (MGMT) methylation status does not correlate with temozolomide (TMZ) sensitivity in all IDH-wildtype glioblastoma (GBM) patients. New predictors of TMZ benefit are still in demand. MethodsBased on MR images, a deep learning image signature was constructed to predict the survival and benefit of temozolomide in patients with IDH wild-type glioblastoma. ResultsDiS signature was associated with OS as an independent prognostic factor in patients with IDH-wildtype glioblastoma. For high-risk group patients, TMZ was associated with improved OS for patients in MGMT-methylated subgroup (HR: 2.051, 95 % CI: 0.939–4.482, log-rank P = 0.034), but had not effect on MGMT-unmethylated patients. However, patients in the low- risk group did not benefit from TMZ. ConclusionDiS could offer complementary value beyond MGMT methylation status in predicting survival benefit from TMZ chemotherapy in patients with IDH-wildtype glioblastoma.