Confounding factors in diagnostics of MGMT promoter methylation status in glioblastomas in stereotactic biopsies

Lutz M. Weise, Patrick N. Harter, Sebastian Eibach, Anne K. Braczynski, Maika Dunst, Johannes Rieger, Oliver Bähr, Elke Hattingen, Joachim P. Steinbach, Karl H. Plate, Volker Seifert, Michel Mittelbronn

Research output: Contribution to journalArticleResearchpeer-review

15 Citations (Scopus)


Background: In nonresectable glioblastoma (GBM), stereotactic biopsies are performed to retrieve tissue for diagnostic purposes. The analysis of O 6-methylguanine-DNA methyltransferase (MGMT) promoter methylation adds prognostic and predictive information. Objectives: The aim of the study was to detect confounding factors that limit the number of conclusive MGMT promoter methylation results. Methods: We analyzed 71 consecutive GBM patients undergoing stereotactic biopsy on whom MGMT analysis was performed by methylation-specific polymerase chain reaction. Specimens were correlated to imaging by coregistration and prospective documentation of biopsy localization. Our findings were validated in an additional 62 GBM stereotactic biopsies. Results: Our results demonstrate that the best MGMT promoter methylation results were obtained from samples (n = 71) taken in a tangential manner from tumor areas showing contrast enhancement in magnetic resonance imaging. In the additional validation series of 62 stereotactically biopsied GBM, we were able to increase the rate of conclusive MGMT promoter methylation results from 76.1 to 85.48% by strictly planning the route of biopsy in a tangential manner if possible. Conclusions: These results underline that within the contrast-enhanced tumor part, choosing the trajectory in a tangential manner increases the diagnostic yield for conclusive MGMT promoter methylation analyses in stereotactic biopsies as a basis for patient stratification and individualized therapy.

Original languageEnglish
Pages (from-to)129-139
Number of pages11
JournalStereotactic and Functional Neurosurgery
Issue number3
Publication statusPublished - Jun 2014
Externally publishedYes


  • MGMT
  • Methylation
  • Promoter
  • Stereotactic biopsy


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