September 17, 2025

CBV-informed MR Fingerprinting for Improved Classification of Intratumoral Heterogeneity in Post-Treatment Glioblastomas

Key Points

The MRF/CBV-informed signatures improve classification of local tumor recurrence in glioblastomas.
Evaluation of 97 patients demonstrated improved accuracy over biopsy-defined metrics for intratumoral heterogeneity.
A prospective analysis of 14 patients correlated imaging signatures with histopathological findings, enhancing diagnostic precision.
The developed approach calls for more refined tumor sampling methods and improved evaluation of treatment responses.

Abstract

Motivation: Post-treatment glioblastoma lesions often present with both local tumor recurrence and radiation necrosis. Segmenting within-lesion heterogeneity is clinically challenging. Cerebral blood volume (CBV) maps can inform high-risk areas, but with limited specificity. Goal(s): We aim to extend the use of MR Fingerprinting (MRF) from whole-lesion classification to better characterize within-lesion heterogeneity and local recurrence, with histopathological validation. Approach: We propose 1) a retrospective cohort (n=97) that develops MRF-CBV TR signatures from CBV-defined high-risk regions, and 2)a prospective validation cohort (n=14) that correlates the developed metrics with multi-location histopathological samples within lesion, and compares performance of CBV-defined versus biopsy-defined MRF signatures. Impact: The MRF/CBV-informed local tumor recurrance signatures can improve characterization of intratumoral heterogeneity beyond CBV in recurrent glioblastomas. This pipeline will lead to more precise tumor sampling and better treatment response evaluation.

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