MRI features and prognostic evaluation in patients with subventricular zone-contacting IDH-wild-type glioblastoma

Abstract

Background. The subventricular zone (SVZ), the brain's largest neural stem cells reservoir, plays a critical role in glioblastoma development and progression. This study aims to investigate the association between MRI features and SVZ contact in IDH-wild-type glioblastoma and their prognostic significance to guide personalized diagnosis and treatment.

Patients and methods. We retrospectively analyzed the MRI and clinical data of 371 patients with IDH-wild-type glioblastoma from The Cancer Imaging Archive. Tumors were classified into SVZ contact and non-contact groups based on the spatial relationships between contrast-enhanced lesions and the SVZ on T1C imaging. Group differences were analyzed, and survival outcomes were assessed using Cox regression and Kaplan-Meier analyses.

Results. SVZ contact was observed in 64.4% of patients, these patients exhibited significantly shorter overall survival (OS) compared to the SVZ non-contact group (11.0 vs. 17.5 months, p < 0.001), larger tumor size (5.07 vs. 3.31 cm, p < 0.001), and higher rates of crossing midline (11.7% vs. 0%, p < 0.001). They also showed higher rates of cystic lesions and necrosis. Cox regression confirmed SVZ contact as an independent predictor of poor OS (p = 0.027), alongside multifocal lesions and age. OS significantly differed by SVZ contact regions (p < 0.001), with temporal horn contact linked to longer OS and body contact to shorter OS.

Conclusions. SVZ contact is an independent prognostic factor for OS in IDH-wild-type glioblastoma, they exhibit larger size, higher rates of crossing midline, and multifocality. Prognostic differences among SVZ contact regions warrant further investigation to explore the role of their distinct microenvironments.

Keywords: Glioblastoma; Subventricular zone; Overall survival; MRI feature; Prognosis