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Functional connectivity within glioblastoma impacts overall survival.

Authors
  • Daniel, Andy G S1
  • Park, Ki Yun2
  • Roland, Jarod L3, 4
  • Dierker, Donna2
  • Gross, James5
  • Humphries, Joseph B1
  • Hacker, Carl D6
  • Snyder, Abraham Z2
  • Shimony, Joshua S2
  • Leuthardt, Eric C1, 3, 6, 7, 8, 9, 10
  • 1 Department of Biomedical Engineering, McKelvey School of Engineering, Washington University, St. Louis, Missouri.
  • 2 Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri.
  • 3 Washington University School of Medicine, St Louis, Missouri.
  • 4 Department of Neurological Surgery, University of California San Francisco, San Francisco, California.
  • 5 School of Medicine, St Louis, Missouri.
  • 6 Department of Neurological Surgery, St Louis, Missouri.
  • 7 Department of Neuroscience, St Louis, Missouri.
  • 8 Department of Mechanical Engineering and Materials Science, St Louis, Missouri.
  • 9 Center for Innovation in Neuroscience and Technology, St Louis, Missouri.
  • 10 Brain Laser Center, St Louis, Missouri.
Type
Published Article
Journal
Neuro-Oncology
Publisher
Oxford University Press
Publication Date
Mar 25, 2021
Volume
23
Issue
3
Pages
412–421
Identifiers
DOI: 10.1093/neuonc/noaa189
PMID: 32789494
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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. 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. 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. 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. © The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Neuro-Oncology.

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