The purpose of this study was to interrogate the inter-dependence of perfusion and diffusion imaging, and further investigate the clinical relevance of the inter-dependence of perfusion and diffusion, using a glioblastoma cohort containing 115 patients. A statistical method, the empirical copula transform, was applied obtain the joint distribution of perfusion and diffusion imaging, which was then discretized to extract second-order features for hierarchical patient clustering. Three patient subgroups were identified which showed significantly different overall survival and progression-free survival. The results showed that the inter-dependence between perfusion and diffusion imaging may be useful in stratifying patients and evaluating tumor invasiveness.
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