Variations of ITSS‐Morphology and their Relationship to Location and Tumor Volume in Patients with Glioblastoma

BACKGROUND Susceptibility weighted imaging and assessment of intratumoral susceptibility signal (ITSS) morphology is used to identify high-grade glioma (HGG) in patients with suspected brain neoplasm. PURPOSE The aim of this study was to outline variations in ITSS-morphology and their relationship to location as well as volume of the lesion in patients with glioblastoma (GB). MATERIALS AND METHODS Contrast-enhanced SWI (CE-SWI) images of 40 patients with histologically confirmed GB were analyzed retrospectively with particular attention to ITSS-morphology dividing all lesions into two groups. Considering the location of the lesion within brain parenchyma, lesions with and without involvement of the subventricular zone (SVZ+/SVZ−) were discerned. Additionally, the contrast-enhancing tumor volume was evaluated. Statistical analysis was based on a classification analysis resulting in a classification rule (tree) as well as Mann-Whitney-U test. RESULTS The distribution of ITSS-scores showed differences between the SVZ+ and SVZ− groups. While SVZ-GB showed only fine-linear or dot-like ITSS, in SVZ+ GB the ITSS-morphology changed with the tumor volume, that is, in larger tumors dense and conglomerated ITSS were the predominant finding. CONCLUSION Our findings indicate that ITSS-morphology is not a random phenomenon. Location of GB, as well as tumor volume, appear to be factors contributing to ITSS morphology.