Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

The Prognostic Role of the Volumetric MRI Evaluation in the Surgical Treatment of Glioblastoma

Denis Aiudi
* ORCID logo ,
Alessio Iacoangeli
ORCID logo ,
Mauro Dobran
,
Gabriele Polonara
,
Mario Chiapponi
ORCID logo ,
Andrea Mattioli
,
Maurizio Gladi
,
Maurizio Iacoangeli
Version 1 : Received: 26 September 2023 / Approved: 27 September 2023 / Online: 28 September 2023 (03:26:09 CEST)

A peer-reviewed article of this Preprint also exists.

Aiudi, D.; Iacoangeli, A.; Dobran, M.; Polonara, G.; Chiapponi, M.; Mattioli, A.; Gladi, M.; Iacoangeli, M. The Prognostic Role of Volumetric MRI Evaluation in the Surgical Treatment of Glioblastoma. J. Clin. Med. 2024, 13, 849. Aiudi, D.; Iacoangeli, A.; Dobran, M.; Polonara, G.; Chiapponi, M.; Mattioli, A.; Gladi, M.; Iacoangeli, M. The Prognostic Role of Volumetric MRI Evaluation in the Surgical Treatment of Glioblastoma. J. Clin. Med. 2024, 13, 849.

Abstract

Background: Glioblastoma is the most common primary brain neoplasm in adults, with still a poor prognosis despite a constant effort to improve patients’ survival. Some neuroradiological volumetric parameters seem to play a predictive role on Overall Survival (OS) and Progression Free Survival (PFS). The aim of this study is to analyze the impact that the volumetric areas of contrast-enhancing tumor and perineoplastic edema have on survival of patients treated for glioblastoma; Methods: A series of 87 patients who underwent surgery was retrospectively analyzed; OS and PFS were considered as the end points of the study. For each patient a multidisciplinary revision was conducted in collaboration with the Neuroradiology and Neuro-Oncology board. A manual and semi-automatic measurement were adopted to perform the radiological evaluation: contrast Enhancement Preoperative (CE-PTV) and Postoperative Tumor Volume (CE-RTV), Edema/Infiltration Preoperative (T2/FLAIR-PV) and Postoperative Volume (T2/FLAIR-RV); necrosis volume inside the tumor (NV); total tumor volume, including necrosis (TV); Results: The median OS value was 9 months and the median PFS value was 4 m; the mean values were respectively 12,3 m and 6,9 m. Multivariate analysis showed that the OS related factors were: adjuvant chemo-radiotherapy (p < 0,0001), CE-PTV < 15 cm³ (p=0,03), surgical resection > 95% (p=0,004) and the presence of a “pseudo-capsulated” radiological morphology (p=0,04); Conclusions: maximal safe resection is one of the most relevant predictive factors for patients’ survival. The semi-automatic pre-operative MRI evaluation could play a key role in prognostically categorizing these tumors.

Keywords

FLAIR infiltration; brain tumors; extent of surgical resection; glioblastoma; overall survival; progression-free survival; pseudocapsule; neuro-oncology; tumor volume

Subject

Medicine and Pharmacology, Neuroscience and Neurology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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