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Abstract #2543

Contralateral Neurofluid Dynamics Predict Survival in IDH Wild-type Glioblastoma: A DTI-ALPS and Free Water Imaging Study

Wataru Uchida1,2, Akifumi Hagiwara2, Takuya Ozawa2, Kaito Takabayashi2, Christina Andica1,2, Junko Kikuta2, Tomoko Maekawa2, Toshiaki Akashi2, Akihiko Wada2, Koji Kamagata2, Osamu Akiyama3, Akihide Kondo3, and Shigeki Aoki1,2
1Faculty of Health Data Science, Juntendo University, Chiba, Japan, 2Juntendo University Graduate School of Medicine, Tokyo, Japan, 3Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan

Synopsis

Keywords: Tumors (Pre-Treatment), Neurofluids

Motivation: Neuroinflammation and glymphatic dysfunction in glioblastoma may extend beyond the tumor site, potentially affecting patient outcomes.

Goal(s): To evaluate DTI-ALPS and free water imaging as biomarkers for assessing neurofluid dynamics in glioblastoma patients.

Approach: We analyzed 277 patients with IDH wild-type glioblastoma, comparing tumor regions with normal-appearing white matter in both hemispheres and performed survival analysis.

Results: Lower ALPS-index and higher free water volume fraction in contralateral normal-appearing white matter significantly associated with shorter survival time, independent of tumor volume, suggesting their utility as prognostic imaging biomarkers. Future applications could include patient selection and response monitoring for immunotherapy.

Impact: Lower ALPS-index and higher free water volume fraction in contralateral normal-appearing white matter predict poor survival in glioblastoma patients. These non-invasive imaging biomarkers may help assess disease severity and monitor treatment response, potentially improving personalized therapeutic strategies in glioblastoma management.

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