We report a novel clinical putative glioblastoma (GBM) biomarker of infiltration which predicts overall survival at presentation. Given the extreme challenges in obtaining comprehensive spatially matched MRI and tissue in humans to explore the biomarker biology, we assessed the relation between tumoral cellularity and ADC values in matched histology and MRI in a rodent infiltrating human xenograft GBM model. We demonstrate that the ADC slope measured along linear profiles perpendicular to the boundary of solid macroscopic tumor visible on ADC is a biomarker predictive of overall survival in a single centre human cohort. We demonstrate a strong correlation between ADC and tumor cellularity in the preclinical model, supporting the hypothesis that a radial vectorial profile analysis of tumor ADC maps could provide with a robust clinical biomarker of glioblastoma cell infiltration and therefore outcome.
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