Tumour surface regularity predicts survival and benefit from gross total resection in IDH-wildtype glioblastoma patients.

in Insights into imaging by Peng Lin, Jin-Shu Pang, Ya-Dan Lin, Qiong Qin, Jia-Yi Lv, Gui-Qian Zhou, Tian-Ming Tan, Wei-Jia Mo, Gang Chen

TLDR

  • The study found that tumour sphericity is an independent predictor of overall survival in IDH-wildtype GBMs, and that high tumour sphericity may not benefit from gross tumour resection.

Abstract

To evaluate the ability of sphericity in glioblastomas (GBMs) for predicting overall survival (OS) and the survival benefit from gross tumour resection (GTR). Preoperative MRI scans were retrospectively analysed in IDH-wildtype GBM patients from two datasets. After MRI preprocessing and tumour segmentation, tumour sphericity was calculated based on the tumour core region. The prognostic value of tumour surface regularity was evaluated via Kaplan-Meier (K-M) plots, univariate and multivariate Cox proportional hazards analyses. In different surface regularity subgroups, the OS benefit from GTR was evaluated via K-M plots and the restricted mean survival time (RMST). This study included 367 patients (median age, 62.0 years [IQR, 54.5-70.5 years]) in the discovery cohort and 475 patients (median age, 63.6 years [IQR, 56.2-71.3 years]) in the validation cohort. Sphericity was an independent predictor of OS in the discovery (p = 0.022, hazard ratio (HR) = 1.45, 95% confidence interval (CI) 1.06-1.99) and validation groups (p = 0.007, HR = 1.38, 95% CI: 1.09-1.74) according to multivariate analysis. Age, extent of resection, and surface regularity composed a prognostic model that separated patients into subgroups with distinct prognoses. Patients in the surface-irregular subgroup benefited from GTR, but patients in the surface-regular subgroup did not in the discovery (p < 0.001 vs. p = 0.056) and validation datasets (p < 0.001 vs. p = 0.11). The high surface regularity of IDH-wildtype GBM is significantly correlated with better OS and does not benefit substantially from GTR. The proposed imaging marker has the potential to increase the survival prediction efficacy for IDH-wildtype glioblastomas (GBMs), offering a valuable indicator for clinical decision-making. Sphericity is an independent prognostic factor in IDH-wildtype glioblastomas (GBMs). High sphericity in IDH-wildtype GBM is significantly correlated with better survival. GBM patients with low sphericity could receive survival benefits from gross tumour resection.

Overview

  • The study aims to evaluate the ability of tumour sphericity in glioblastomas (GBMs) for predicting overall survival (OS) and the survival benefit from gross tumour resection (GTR).
  • The study includes preoperative MRI scans from IDH-wildtype GBM patients from two datasets, with a total of 842 patients. The tumour sphericity was calculated based on the tumour core region.
  • The primary objective is to identify an imaging marker that can increase the survival prediction efficacy for IDH-wildtype GBMs and offer a valuable indicator for clinical decision-making.

Comparative Analysis & Findings

  • The study found that tumour sphericity was an independent predictor of OS in both the discovery and validation groups, with a higher sphericity indicating better OS.
  • The surface regularity of the tumour was found to be significantly correlated with OS, with high surface regularity indicating better OS.
  • The study showed that patients with low tumour sphericity benefited from GTR, while patients with high tumour sphericity did not benefit substantially from GTR.

Implications and Future Directions

  • The proposed imaging marker has the potential to increase the survival prediction efficacy for IDH-wildtype GBMs, offering a valuable indicator for clinical decision-making.
  • Future studies could explore the use of tumour sphericity as a predictor of response to different treatment modalities.
  • Additionally, future studies could investigate the correlation between tumour sphericity and other clinical and molecular factors in GBMs.
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