Work

Nimg-17. Structural Deformation Field on T1w Mri in Healthy Brain Parenchyma Is Associated With Overall Survival in Treatment-naïve Glioblastoma Multiforme

Year: 2017

Type: article

Abstract: Infiltrative nature of glioblastoma multiforme (GBM) forces the compression of surrounding brain tissue resulting in increased intracranial pressure and tissue deformation. Here we characterize the systemic nature of GBM by capturing the heterogeneity in tissue deformation in the normal-appearing brain-around-tumor (BAT) regions on treatment-naïve T1w MRI, and employ these deformation features to distinguish long-term (LTS) from short-term (STS) survivors. We hypothesize that BAT regions in STS would have significantly higher heterogeneity of deformation, as compared to LTS. A total of 79 (41 STS, overall survival<240 days and 38 LTS, OS>540 days) 3-Tesla treatment-naive Gadolinium (Gd)-contrast T1w, T2w, and FLAIR MRI GBM studies were obtained from the Cancer Imaging Archive. An expert reader segmented the necrotic core, active tumor and peritumoral brain zone (PBZ). Voxel-wise deformation magnitude was obtained from the deformation orientations after registration to a normal T1w template. Deformation statistics were computed within 5mm annular BAT regions (0<d<60mm where d is the distance from the PBZ). The results demonstrated that the deformation magnitude was positively skewed in STS as compared to LTS. The distributions were found to be statistically different (p<0.05) for 0<d<30mm, implying that structural deformation is, possibly, more unevenly spread in BAT regions right next to PBZ as compared to relatively distal regions. Kaplan-Meier survival analysis and log-rank test yielded a statistically significant p-value of 0.03. A structural deformation field was found to exist in healthy brain parenchyma in treatment-naïve GBM subjects, with statistical significant differences between the two survival cohorts existing up until 30mm outside the PBZ boundary. These deformation distribution measures were also found to be associated with overall patient survival.

Source: Neuro-Oncology

DOI: 10.1093/neuonc/nox168.595