Abstract

Background

Glioblastoma (GBM; World Health Organization grade IV) assumes a variable appearance on MRI owing to heterogeneous proliferation and infiltration of its cells. As a result, the neurovascular units responsible for functional connectivity (FC) may exist within gross tumor boundaries, albeit with altered magnitude. Therefore, we hypothesize that the strength of FC within GBMs is predictive of overall survival.

Methods

We used predefined FC regions of interest (ROIs) in de novo GBM patients to characterize the presence of within-tumor FC observable via resting-state functional MRI and its relationship to survival outcomes.

Results

Fifty-seven GBM patients (mean age, 57.8 ± 13.9 y) were analyzed. Functionally connected voxels, not identifiable on conventional structural images, can be routinely found within the tumor mass and was not significantly correlated to tumor size. In patients with known survival times (n = 31), higher intranetwork FC strength within GBM tumors was associated with better overall survival even after accounting for clinical and demographic covariates.

Conclusions

These findings suggest the possibility that functionally intact regions may persist within GBMs and that the extent to which FC is maintained may carry prognostic value and inform treatment planning.

中文翻译：

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胶质母细胞瘤内的功能连接影响整体生存

摘要

背景

胶质母细胞瘤（GBM；世界卫生组织IV级）由于其细胞的异质增殖和浸润而在MRI上呈现出不同的外观。结果，负责功能连接性（FC）的神经血管单位可能存在于总体肿瘤边界内，尽管幅度有所改变。因此，我们假设GBM中FC的强度可预测整体存活率。

方法

我们在GBM新生患者中使用了预定义的FC感兴趣区域（ROI），以表征通过静息状态功能MRI可观察到的肿瘤内FC的存在及其与生存结果的关系。

结果

分析了57例GBM患者（平均年龄57.8±13.9岁）。在常规结构图像上无法识别的功能连接的体素可以在肿瘤块内常规发现，并且与肿瘤大小没有显着相关性。在已知生存时间（n =  31）的患者中，即使考虑了临床和人口统计学协变量，GBM肿瘤内较高的网络内FC强度也与较好的总体生存率相关。

结论

这些发现提示功能完整的区域可能会保留在GBM中，并且FC维持的程度可能具有预后价值并告知治疗计划。