Abstract
Introduction
Glioblastoma Multiforme(GBM) is an aggressive, incurable brain tumor that presents with seizures in roughly one-third of patients. Quantitative MRI features have emerged as promising imaging markers for predicting glioma-associated epilepsy, but evidence in glioblastoma remains limited. In this study, we analyzed MRI scans of GBM patients to uncover relationships between the tumor core, peritumoral edema, and cerebrospinal fluid(CSF) according to seizure status.
Methods
Preoperative MRI scans from 22 patients in the publicly available Ivy Glioblastoma Atlas Project (Ivy GAP) were obtained through The Cancer Imaging Archive (TCIA) in the modalities of T1-weighted(T1w), T1-post contrast(T1-CE), T2-weighted(T2w), and T2 fluid attenuated inversion recovery(T2 FLAIR). Variables were compared using two-sided exact permutation Mann-Whitney U tests, exact Wilcoxon signed-rank tests, and Fisher’s exact tests, with a p 0.05 considered statistically significant.
Results
The analysis compared several volumetric ratios involving the tumor core, peritumoral edema, and CSF stratified by seizure history. Patients with a seizure history(n=5) had higher median edema-to tumor core and edema-to-CSF ratios compared to patients without a seizure history, though these findings were not statistically significant.
CONCLUSIONS: Although no volumetric ratios differed significantly between the seizure-history and no-seizure-history groups, the numerical differences in edema-related ratios warrant validation in larger, more balanced cohorts. Future studies should integrate these quantitative imaging features with relevant clinical and molecular markers to better understand their potential relationship with seizure status in GBM.