Predictive value of brain tumor reporting and data system scores for functional outcomes and progression-free survival in glioblastoma

The Brain Tumor Reporting and Data System (BT-RADS) is a standardized reporting system developed for routine clinical use for MRI interpretation in patients with primary brain tumors. This study evaluates the BT-RADS predictive value in glioblastoma (GBM) for patient functional outcomes assessed through the Karnofsky Performance Scale (KPS) score and PFS.

This retrospective study includes 94 adult patients with newly diagnosed GBM at Emory University Hospital from January 2019 to January 2023. Predictor variables included BT-RADS scores recorded from MRIs ∼3 months (BT-RADS_A) and ∼9 months post-resection or biopsy (BT-RADS_B), with scores classified as low (BT-RADS score 0-3a) or high (BT-RADS score 3b-4). Outcome variables included PFS and KPS scores at 1 year post-diagnosis, with scores of 70-100% classified as favorable and 0-60% classified as unfavorable. Covariates included O6-methylguanine-DNA methyltransferase (MGMT) methylation status.

In a univariate logistic regression analysis, BT-RADS_A was a significant predictor (P = .04) in discriminating an unfavorable KPS from a favorable one. In a multivariate logistic regression, the best model fit was the model containing BT-RADS_A and tumor MGMT methylation status (P = .03). In a model of BT-RADS_A and BT-RADS_B, accounting for MGMT methylation status, the risk of tumor progression was 50% lower (P = .003) with a low BT-RADS (0-3a) in the BT-RADS_A group and 38% lower (P = .03) with a low BT-RADS (0-3a) in the BT-RADS_B group.

BT-RADS scores can predict functional outcomes and PFS in newly diagnosed GBM patients at ∼3 and ∼9 months post-diagnosis. Future studies are warranted to validate these findings and refine predictive models.