Keywords: Tumors (Pre-Treatment), Tumor, perfusion, glioma
Motivation: Deliniating non-angiogenic and early-angiogenic areas of tumor prevents detection of the full extent of glioblastoma invasion.
Goal(s): This study investigated the relationship between perfusion and radio-pathomic estimates of cell density in glioblastoma.
Approach: This study compared ASL- and DSC-based perfusion estimates to predicted cellularity maps in two large publicly available datasets.
Results: Positive cellularity-perfusion associations were observed within contrast enhancement but not in non-enhancing regions. Per-subject positive cellularity-perfusion associations within FLAIR hyperintensity were associated with worse prognosis in glioblastoma patients following gross total resection.
Impact: Areas of increased perfusion and hypercellularity can be used to direct surgical intervention to capture early-angiogenic areas of tumor missed by contrast enhancement, which may in turn improve survival outcomes. Non-angiogenic hypercellular tumor may persist outside even this margin.
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