Quantification of Tissue Compression Identifies High-Grade Glioma Patients with Reduced Survival

Abstract

The compression of peritumoral healthy tissue in brain tumor patients is considered a major cause of the life-threatening neurologic symptoms. Although significant deformations caused by the tumor growth can be observed radiologically, the quantification of minor tissue deformations have not been widely investigated. In this study, we propose a method to quantify subtle peritumoral deformations. A total of 127 MRI longitudinal studies from 23 patients with high-grade glioma were included. We estimate longitudinal displacement fields based on a symmetric normalization algorithm and we propose four biomarkers. We assess the interpatient and intrapatient association between proposed biomarkers and the survival based on Cox analyses, and the potential of the biomarkers to stratify patients according to their survival based on Kaplan–Meier analysis. Biomarkers show a significant intrapatient association with survival (p < 0.05); however, only compression biomarkers show the ability to stratify patients between those with higher and lower overall survival (AUC = 0.83, HR = 6.30, p < 0.05 for CompCH). The compression biomarkers present three times higher Hazard Ratios than those representing only displacement. Our study provides a robust and automated method for quantifying and delineating compression in the peritumoral area. Based on the proposed methodology, we found an association between lower compression in the peritumoral area and good prognosis in high-grade glial tumors.

MRI Elastography Identifies Regions of Extracellular Matrix Reorganization Associated with Shorter Survival in Glioblastoma Patients

“…MRE probes the shear properties of tissue, while the probing by surgical tools involves a more complex process, as the tissue could also be compressed and compromised. Furthermore, tumor growth can compress surrounding tissue, generating solid stress due to swelling 47,48 . Several studies have found that MRE is sensitive to compressive stress 49,50 .…”

Advancements in Image-Based Models for High-Grade Gliomas Might Be Accelerated

“…The compression of healthy peritumoral tissue in brain tumor patients is considered a major cause of life-threatening neurological symptoms. After examining longitudinal MRI studies of patients with HGG, Fuster-Garcia et al published a methodology for quantifying subtle peritumoral deformations and relating them to patient overall survival (OS) (Figure 3A,B) (Table 1) [31]. As expected, lower tumor compression on surrounding tissues was associated with greater patient survival.…”

“…229 MRI exams from 27 patients with histologically confirmed HGG. [31] APTw MRI imaging shows good scan-rescan reproducibility in healthy tissue and tumors.…”

Structural and functional vascular dysfunction within brain metastases is linked to pembrolizumab inefficacy

“…Consistent with prior work 24,38,42,[55][56][57] , all MRI-derived maps were normalized to reference tissue using NordicIce. As BM encompass both grey matter (GM) and white matter (WM), reference tissue was defined by the WM and GM masks 22,30,42,[58][59][60][61][62] , excluding areas with contrast enhancement and abnormal T2weighted/FLAIR hyperintensity. All analyses were performed with normalized values 38,[55][56][57]63 , which is a unit-less ratio of absolute voxel values to the reference tissue.…”