Abstract
Introduction: Proneural and mesenchymal subtypes are the most distinct demarcated categories in classification scheme, and there is often a shift from proneural type to mesenchymal subtype in the progression of glioblastoma (GBM). The molecular characters are determined by specific genomic methods, however, the application of radiography in clinical practice remains to be further studied. Here, we studied the topography features of GBM in proneural subtype, and further demonstrated the survival characteristics and proneural-mesenchymal transition (PMT) progression of samples by combining with the imaging variables.Methods: Data were acquired from The Cancer Imaging Archive (TCIA, http://cancerimagingarchive.net). The radiography image, clinical variables and transcriptome subtype from 223 samples were used in this study. Proneural and mesenchymal subtype on GBM topography based on overlay and Voxel-based lesion-symptom mapping (VLSM) analysis were revealed. Besides, we carried out the comparison of survival analysis and PMT progression in and outside the VLSM-determined area.Results: The overlay of total GBM and separated image of proneural and mesenchymal subtype revealed a correlation of the two subtypes. By VLSM analysis, proneural subtype was confirmed to be related to left inferior temporal medulla, and no significant voxel was found for mesenchymal subtype. The subsequent comparison between samples in and outside the VLSM-determined area showed difference in overall survival (OS) time, tumor purity, epithelial-mesenchymal transition (EMT) score and clinical variables.Conclusions: PMT progression was determined by radiography approach. GBM samples in the VLSM-determined area tended to harbor the signature of proneural subtype. This study provides a valuable VLSM-determined area related to the predilection site, prognosis and PMT progression by the association between GBM topography and molecular characters.
Highlights
Proneural and mesenchymal subtypes are the most distinct demarcated categories in classification scheme, and there is often a shift from proneural type to mesenchymal subtype in the progression of glioblastoma (GBM)
VLSM associated proneural subtype with lesions to a cluster of the left inferior temporal medulla, while no significant voxel was found for mesenchymal subtype (Figure 4)
We found potential relevance between proneural subtype and mesenchymal subtype on GBM topography based on overlay and VLSM analysis, and survival analysis revealed that patients with GBM in the VLSM-determined area survived longer than patients with GBM outside the VLSM-determined area
Summary
Proneural and mesenchymal subtypes are the most distinct demarcated categories in classification scheme, and there is often a shift from proneural type to mesenchymal subtype in the progression of glioblastoma (GBM). We studied the topography features of GBM in proneural subtype, and further demonstrated the survival characteristics and proneural-mesenchymal transition (PMT) progression of samples by combining with the imaging variables. As a non-invasive checking method, MRI is capable of conducting qualitative and quantitative analysis with specific phenotypic imaging features, to associate with potential prognosis and characteristics [4]. The genomic characteristics of heterogeneous MRI features in GBM are investigated and determined by scholars in a growing number of studies, which provide chances for grouping, prognostication and innovation of targeted therapies [5, 6]. As a newly developed terminology, Visually Accessible Rembrandt Images (VASARI) feature set (https://wiki.nci.nih.gov/display/CIP/VASARI) incorporates various visible subjective imaging features, which is designed to normalize grading of the distinct features of gliomas on MRI, containing different grades criteria corresponding to diverse score to depict severity [7]
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