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Purpose <p>Recurrent glioblastomas showing a survival benefit from anti-VEGF agents are known to exhibit a distinct diffusion MRI phenotype. We aim to characterize advanced imaging features of this glioblastoma subset.</p> Methods <p>MRI scans from 87 patients with IDH-wildtype glioblastoma were analyzed. All patients had completed standard chemoradiation and were anti-VEGF-naïve. Contrast-enhancing tumor segmentations were used to extract: the lowest peak of the double gaussian distribution of apparent diffusion coefficient values (ADC<sub>L</sub>) calculated from diffusion MRI, relative cerebral blood flow (rCBV) values from perfusion MRI, MTR<sub>asym</sub> @ 3ppm from pH-weighted amine CEST MRI, quantitative T<sub>2</sub> and T<sub>2</sub>* relaxation times (qT<sub>2</sub> and qT<sub>2</sub>*), T<sub>1</sub>w subtraction map values, and contrast-enhancing tumor volume. Lesions were categorized as high- or low-ADC<sub>L</sub> using a cutoff of 1240 µm<sup>2</sup>/s, according to previous studies.</p> Results <p>High-ADC<sub>L</sub> lesions showed significantly lower rCBV (1.02 vs. 1.28, <i>p</i> = 0.0057), higher MTR<sub>asym</sub> @ 3ppm (2.36% vs. 2.10%, <i>p</i> = 0.0043), and higher qT<sub>2</sub> (114.8 ms vs. 100.9 ms, <i>p</i> = 0.0094), compared to low-ADC<sub>L</sub> lesions. No group differences were seen in contrast-enhancing tumor volume, T<sub>1</sub>w subtraction map values, and qT<sub>2</sub>*, nor in clinical variables such as sex category, MGMT status, and EGFR status. Finally, no clear group-specific preferential locations were seen.</p> Conclusion <p>Post-chemoradiation glioblastomas with a diffusion MRI phenotype that is known to predict a favorable response to anti-VEGF (ADC<sub>L</sub> ≥1240 µm<sup>2</sup>/s) have distinct biological features, with different perfusion and metabolic characteristics, and T<sub>2</sub> relaxation times.</p>

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Advanced imaging characterization of post-chemoradiation glioblastoma stratified by diffusion MRI phenotypes known to predict favorable anti-VEGF response

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月14日

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  • Francesco Sanvito,
  • Irina Kryukov,
  • Jingwen Yao,
  • Ashley Teraishi,
  • Catalina Raymond,
  • John Gao,
  • Cole Miller,
  • Phioanh L. Nghiemphu,
  • Albert Lai,
  • Linda M. Liau,
  • Kunal Patel,
  • Richard G. Everson,
  • Blaine S.C. Eldred,
  • Robert M. Prins,
  • David A. Nathanson,
  • Noriko Salamon,
  • Timothy F. Cloughesy,
  • Benjamin M. Ellingson

摘要

Purpose

Recurrent glioblastomas showing a survival benefit from anti-VEGF agents are known to exhibit a distinct diffusion MRI phenotype. We aim to characterize advanced imaging features of this glioblastoma subset.

Methods

MRI scans from 87 patients with IDH-wildtype glioblastoma were analyzed. All patients had completed standard chemoradiation and were anti-VEGF-naïve. Contrast-enhancing tumor segmentations were used to extract: the lowest peak of the double gaussian distribution of apparent diffusion coefficient values (ADCL) calculated from diffusion MRI, relative cerebral blood flow (rCBV) values from perfusion MRI, MTRasym @ 3ppm from pH-weighted amine CEST MRI, quantitative T2 and T2* relaxation times (qT2 and qT2*), T1w subtraction map values, and contrast-enhancing tumor volume. Lesions were categorized as high- or low-ADCL using a cutoff of 1240 µm2/s, according to previous studies.

Results

High-ADCL lesions showed significantly lower rCBV (1.02 vs. 1.28, p = 0.0057), higher MTRasym @ 3ppm (2.36% vs. 2.10%, p = 0.0043), and higher qT2 (114.8 ms vs. 100.9 ms, p = 0.0094), compared to low-ADCL lesions. No group differences were seen in contrast-enhancing tumor volume, T1w subtraction map values, and qT2*, nor in clinical variables such as sex category, MGMT status, and EGFR status. Finally, no clear group-specific preferential locations were seen.

Conclusion

Post-chemoradiation glioblastomas with a diffusion MRI phenotype that is known to predict a favorable response to anti-VEGF (ADCL ≥1240 µm2/s) have distinct biological features, with different perfusion and metabolic characteristics, and T2 relaxation times.