Tumour surface regularity predicts survival and benefit from gross total resection in IDH-wildtype glioblastoma patients

Abstract Objectives To evaluate the ability of sphericity in glioblastomas (GBMs) for predicting overall survival (OS) and the survival benefit from gross tumour resection (GTR). Methods Preoperative MRI scans were retrospectively analysed in IDH-wildtype GBM patients from two datasets. After MRI pr...

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Main Authors: Peng Lin, Jin-Shu Pang, Ya-Dan Lin, Qiong Qin, Jia-Yi Lv, Gui-Qian Zhou, Tian-Ming Tan, Wei-Jia Mo, Gang Chen
Format: Article
Language:English
Published: SpringerOpen 2025-02-01
Series:Insights into Imaging
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Online Access:https://doi.org/10.1186/s13244-025-01900-2
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author Peng Lin
Jin-Shu Pang
Ya-Dan Lin
Qiong Qin
Jia-Yi Lv
Gui-Qian Zhou
Tian-Ming Tan
Wei-Jia Mo
Gang Chen
author_facet Peng Lin
Jin-Shu Pang
Ya-Dan Lin
Qiong Qin
Jia-Yi Lv
Gui-Qian Zhou
Tian-Ming Tan
Wei-Jia Mo
Gang Chen
author_sort Peng Lin
collection DOAJ
description Abstract Objectives To evaluate the ability of sphericity in glioblastomas (GBMs) for predicting overall survival (OS) and the survival benefit from gross tumour resection (GTR). Methods Preoperative MRI scans were retrospectively analysed in IDH-wildtype GBM patients from two datasets. After MRI preprocessing and tumour segmentation, tumour sphericity was calculated based on the tumour core region. The prognostic value of tumour surface regularity was evaluated via Kaplan–Meier (K-M) plots, univariate and multivariate Cox proportional hazards analyses. In different surface regularity subgroups, the OS benefit from GTR was evaluated via K-M plots and the restricted mean survival time (RMST). Results This study included 367 patients (median age, 62.0 years [IQR, 54.5–70.5 years]) in the discovery cohort and 475 patients (median age, 63.6 years [IQR, 56.2–71.3 years]) in the validation cohort. Sphericity was an independent predictor of OS in the discovery (p = 0.022, hazard ratio (HR) = 1.45, 95% confidence interval (CI) 1.06–1.99) and validation groups (p = 0.007, HR = 1.38, 95% CI: 1.09–1.74) according to multivariate analysis. Age, extent of resection, and surface regularity composed a prognostic model that separated patients into subgroups with distinct prognoses. Patients in the surface-irregular subgroup benefited from GTR, but patients in the surface-regular subgroup did not in the discovery (p < 0.001 vs. p = 0.056) and validation datasets (p < 0.001 vs. p = 0.11). Conclusions The high surface regularity of IDH-wildtype GBM is significantly correlated with better OS and does not benefit substantially from GTR. Critical relevance statement The proposed imaging marker has the potential to increase the survival prediction efficacy for IDH-wildtype glioblastomas (GBMs), offering a valuable indicator for clinical decision-making. Key Points Sphericity is an independent prognostic factor in IDH-wildtype glioblastomas (GBMs). High sphericity in IDH-wildtype GBM is significantly correlated with better survival. GBM patients with low sphericity could receive survival benefits from gross tumour resection. Graphical Abstract
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spelling doaj-art-a41f4b1d60784d56901e9b2edc4881992025-08-20T02:15:11ZengSpringerOpenInsights into Imaging1869-41012025-02-0116111010.1186/s13244-025-01900-2Tumour surface regularity predicts survival and benefit from gross total resection in IDH-wildtype glioblastoma patientsPeng Lin0Jin-Shu Pang1Ya-Dan Lin2Qiong Qin3Jia-Yi Lv4Gui-Qian Zhou5Tian-Ming Tan6Wei-Jia Mo7Gang Chen8Department of Medical Ultrasound, Fujian Medical University Union HospitalDepartment of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Medical Image, The Third People’s Hospital of GanzhouDepartment of Pathology, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Pathology, The First Affiliated Hospital of Guangxi Medical UniversityDepartment of Pathology, The First Affiliated Hospital of Guangxi Medical UniversityAbstract Objectives To evaluate the ability of sphericity in glioblastomas (GBMs) for predicting overall survival (OS) and the survival benefit from gross tumour resection (GTR). Methods Preoperative MRI scans were retrospectively analysed in IDH-wildtype GBM patients from two datasets. After MRI preprocessing and tumour segmentation, tumour sphericity was calculated based on the tumour core region. The prognostic value of tumour surface regularity was evaluated via Kaplan–Meier (K-M) plots, univariate and multivariate Cox proportional hazards analyses. In different surface regularity subgroups, the OS benefit from GTR was evaluated via K-M plots and the restricted mean survival time (RMST). Results This study included 367 patients (median age, 62.0 years [IQR, 54.5–70.5 years]) in the discovery cohort and 475 patients (median age, 63.6 years [IQR, 56.2–71.3 years]) in the validation cohort. Sphericity was an independent predictor of OS in the discovery (p = 0.022, hazard ratio (HR) = 1.45, 95% confidence interval (CI) 1.06–1.99) and validation groups (p = 0.007, HR = 1.38, 95% CI: 1.09–1.74) according to multivariate analysis. Age, extent of resection, and surface regularity composed a prognostic model that separated patients into subgroups with distinct prognoses. Patients in the surface-irregular subgroup benefited from GTR, but patients in the surface-regular subgroup did not in the discovery (p < 0.001 vs. p = 0.056) and validation datasets (p < 0.001 vs. p = 0.11). Conclusions The high surface regularity of IDH-wildtype GBM is significantly correlated with better OS and does not benefit substantially from GTR. Critical relevance statement The proposed imaging marker has the potential to increase the survival prediction efficacy for IDH-wildtype glioblastomas (GBMs), offering a valuable indicator for clinical decision-making. Key Points Sphericity is an independent prognostic factor in IDH-wildtype glioblastomas (GBMs). High sphericity in IDH-wildtype GBM is significantly correlated with better survival. GBM patients with low sphericity could receive survival benefits from gross tumour resection. Graphical Abstracthttps://doi.org/10.1186/s13244-025-01900-2GlioblastomaMRISphericityExtent of resection
spellingShingle Peng Lin
Jin-Shu Pang
Ya-Dan Lin
Qiong Qin
Jia-Yi Lv
Gui-Qian Zhou
Tian-Ming Tan
Wei-Jia Mo
Gang Chen
Tumour surface regularity predicts survival and benefit from gross total resection in IDH-wildtype glioblastoma patients
Insights into Imaging
Glioblastoma
MRI
Sphericity
Extent of resection
title Tumour surface regularity predicts survival and benefit from gross total resection in IDH-wildtype glioblastoma patients
title_full Tumour surface regularity predicts survival and benefit from gross total resection in IDH-wildtype glioblastoma patients
title_fullStr Tumour surface regularity predicts survival and benefit from gross total resection in IDH-wildtype glioblastoma patients
title_full_unstemmed Tumour surface regularity predicts survival and benefit from gross total resection in IDH-wildtype glioblastoma patients
title_short Tumour surface regularity predicts survival and benefit from gross total resection in IDH-wildtype glioblastoma patients
title_sort tumour surface regularity predicts survival and benefit from gross total resection in idh wildtype glioblastoma patients
topic Glioblastoma
MRI
Sphericity
Extent of resection
url https://doi.org/10.1186/s13244-025-01900-2
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