NeuroImage: Clinical (Jan 2016)

Population-based MRI atlases of spatial distribution are specific to patient and tumor characteristics in glioblastoma

  • Michel Bilello,
  • Hamed Akbari,
  • Xiao Da,
  • Jared M. Pisapia,
  • Suyash Mohan,
  • Ronald L. Wolf,
  • Donald M. O’Rourke,
  • Maria Martinez-Lage,
  • Christos Davatzikos

DOI
https://doi.org/10.1016/j.nicl.2016.03.007
Journal volume & issue
Vol. 12, no. C
pp. 34 – 40

Abstract

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Background and purpose: In treating glioblastoma (GB), surgical and chemotherapeutic treatment guidelines are, for the most part, independent of tumor location. In this work, we compiled imaging data from a large cohort of GB patients to create statistical atlases illustrating the disease spatial frequency as a function of patient demographics as well as tumor characteristics. Materials and methods: Two-hundred-six patients with pathology-proven glioblastoma were included. Of those, 65 had pathology-proven recurrence and 113 had molecular subtype and genetic information. We used validated software to segment the tumors in all patients and map them from patient space into a common template. We then created statistical maps that described the spatial location of tumors with respect to demographics and tumor characteristics. We applied a chi-square test to determine whether pattern differences were statistically significant. Results: The most frequent location for glioblastoma in our patient population is the right temporal lobe. There are statistically significant differences when comparing patterns using demographic data such as gender (p = 0.0006) and age (p = 0.006). Small and large tumors tend to occur in separate locations (p = 0.0007). The tumors tend to occur in different locations according to their molecular subtypes (p < 10−6). The classical subtype tends to spare the frontal lobes, the neural subtype tend to involve the inferior right frontal lobe. Although the sample size is limited, there was a difference in location according to EGFR VIII genotype (p < 10−4), with a right temporal dominance for EFGR VIII negative tumors, and frontal lobe dominance in EGFR VIII positive tumors. Conclusions: Spatial location of GB is an important factor that correlates with demographic factors and tumor characteristics, which should therefore be considered when evaluating a patient with GB and might assist in personalized treatment.

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