MRI Radiomic Features of Peritumoral Edema May Predict the Recurrence Sites of Glioblastoma Multiforme

Background: The purpose of this study was to investigate whether there is radiological heterogeneity within peritumoral edema and identify the reproducible radiomic features predictive of the sites of recurrence of glioblastoma multiforme (GBM), which may be of value to optimize patients’ management. Methods: We retrospectively evaluated the clinical information and MR images (T1-weighted and fluid-attenuated inversion recovery sequences) of 22 patients with histologically diagnosed GBM. Kaplan-Meier’s method was used for survival analysis. Peritumoral edema regions were manually segmented by an expert into recurrence and non-recurrence subregions. A set of 94 radiomic features were obtained from both subregions using a three-dimensional slicer. Features with significant differences between the two subregions were identified using the paired t test. Subsequently, the data of two patients from The Cancer Genome Atlas (TCGA) database were used to evaluate the clinical value of the selected features. Findings: Ten features with significant differences between the recurrence and non-recurrence subregions were identified and verified on two individual patients from TCGA database with pathologically confirmed diagnosis of GBM. Interpretation: Our results suggested that heterogeneity does exist in peritumoral edema, indicating that the radiomic features of peritumoral edema from routine MR images can be utilized to predict the sites of GBM recurrence. Our findings may further guide the surgical treatment strategy for GBM. Funding Information: This work was supported by grants from the Natural Science Fund of Guangdong Province (No. 2017A030313597), “Climbing Program” Special Fund of Guangdong Province (No. pdjh2019b0100, No. pdjh2020b0112) and Southern Medical University (No. LX2016N006, No. KJ20161102, No.201912121004S, No.201912121013，No. S202012121088, No. X202012121354). Declaration of Interests: The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. Ethics Approval Statement: Ethics committee approval and patient consent were obtained.