Objective To explore the relationship between comprehensive information of gliomas and O₆-methylguanylmethyltransferase (MGMT) promoter methylation status non-invasively by analyzing radiomic features of multi-modality ¹⁸F-fluorodeoxyglucose (FDG) PET/CT images. The response to temozolomide (TMZ) was determined through the abovementioned method for the clinical management of glioma patients.

Methods A retrospective study of 17 patients (13 males and 4 females) with glioma confirmed by histopathological results in the First Medical Center of General Hospital of Chinese PLA from January 2016 to September 2018 was conducted. Preoperative ¹⁸F-FDG PET/CT scanning was performed. Radiomic texture analysis was performed after manually delineating the volume of interest. MGMT promoter methylation was examined by pyrosequencing analysis. MGMT data were categorized according to the methylation status, i.e., methylated and unmethylated groups. Two independent sample t-tests were used to analyze the differences in imaging omics parameters between the two groups of data.

Results Among the 17 patients with glioma, 9 (52.9%) had MGMT unmethylation and 8 (47.1%) had MGMT methylation. Between the methylated group and the unmethylated group, there was no significant difference in patient age or tumor grade (t=−0.251, −0.016, P=0.806, 0.198); The difference between genders was statistically significant Meaning (t=−1.426, P=0.031). Both the SUV_max and TNR_max values of the MGMT methylated group were significantly higher than those of the MGMT unmethylated group (SUV_max: 18.83±7.77 vs. 9.66±4.13; t=−3.095, P=0.007; TNR_max: 2.37±0.87 vs. 1.20±0.52; t=−3.402, P=0.004).

Conclusion The features (SUV_max and TNR_max) of ¹⁸F-FDG PET/CT images are two key indicators in the detection of MGMT methylation status in gliomas and are valuable predictors of the clinical responses of patients scheduled to receive TMZ chemotherapeutics.