Noninvasive assessment of glymphatic system alterations as potential biomarkers for predicting overall survival in glioma

作者：Qian Li, Xuetong Tao, Xuanle Li, Xiqian Zhang, Heng Wang, Jing Qin, Jia Gu, Rongde Zhong, N. J. Zhang · 发表于：Journal of neurosurgery · 年份：2025 · DOI：10.3171/2025.5.jns243268 · 被引用次数：3 · 研究领域：Cerebrospinal fluid and hydrocephalus、Glioma Diagnosis and Treatment、Advanced Neuroimaging Techniques and Applications

OBJECTIVE: In this retrospective study, authors aimed to evaluate the glymphatic function alterations associated with glioma and explore the prognostic value of these alterations by calculating the index for diffusivity along the perivascular space (ALPS index). METHODS: The authors utilized data from the publicly available University of California San Francisco Preoperative Diffuse Glioma MRI (UCSF-PDGM) dataset, which includes 501 adult patients with histopathologically confirmed diffuse glioma, per the 2021 WHO classification, who underwent preoperative MRI, initial tumor resection, and tumor genetic testing at a single medical center from 2015 to 2021.The ALPS index was calculated from diffusivity maps for noninvasive glymphatic system (GS) analysis. The authors extracted 2288 radiomic features across four tumor regions: surrounding FLAIR abnormality, enhancing tumor, central nonenhancing and/or necrotic tumor, and whole tumor (combining necrosis, enhancement, and edema). For normally distributed variables (adjusted for age, enhancing tumor volume, and surrounding FLAIR abnormality volume), ANCOVA was utilized; nonnormally distributed data were analyzed using the Kruskal-Wallis test and Mann-Whitney U-test. Spearman's correlation coefficients were calculated to assess relationships between radiomic features and the ALPS index. Survival analysis included Kaplan-Meier curves, log-rank tests, concordance index (C-index), calibration and decision curves, and Cox regression. R...