Comparative Analysis of MRI Features and Overall Survival: IDH-Wildtype Diffuse Lower-grade Glioma and Glioblastoma...

In depth comparison of imaging features and overall survival (OS) between IDH wild-type diffuse lower-grade glioma and glioblastoma (GB), providing precise guidance for early risk stratification and optimized clinical decision-making.

Retrospective inclusion of IDH wild-type glioma patients admitted between January 2017 and January 2024. Patients were classified into GB (histological and molecular) and lower-grade glioma not elsewhere classified (LGNEC) based on fifth edition of the Central Nervous System Tumor Classification Standards. Compare the differences in clinical and imaging features between GB (histological and molecular) and LGNEC. Qualitative imaging features include tumor localization, multifocal or multicenter, gyriform infiltration, and contrast enhancement. Quantitative imaging features include relative minimum apparent diffusion coefficient (rADC_min), mean (rADC_mean), and maximum (rADC_max) were obtained by standardization of the contralateral white matter. Maximum cerebral blood flow (CBF_max) was obtained according to the arterial spin labeling map. The visual analysis divided the CBF images into three grades. Further compare the OS differences between GB and LGNEC.

Among the 212 patients, 159 had histological GB, 31 had molecular GB, and 22 had LGNEC. There are significant differences in age, tumor location, multifocal or multicenter, gyriform infiltration, contrast enhancement, rADC_min, rADC_max, rADC_mean, CBF_max, and CBF grade among GB and LGNEC. The median OS for the histological GB was 16.8 months, significantly lower than the 27.9 months for the molecular GB and lower than that of the LGNEC.

Histological GB, molecular GB, and LGNEC show significant differences in clinical, imaging features, and OS.