{"doi":"10.1007/s11060-025-05019-8","title":"Advanced imaging characterization of post-chemoradiation glioblastoma stratified by diffusion MRI phenotypes known to predict favorable anti-VEGF response","abstract":"Abstract Purpose Recurrent glioblastomas showing a survival benefit from anti-VEGF agents are known to exhibit a distinct diffusion MRI phenotype. We aim to characterize advanced imaging features of this glioblastoma subset. Methods MRI scans from 87 patients with IDH-wildtype glioblastoma were analyzed. All patients had completed standard chemoradiation and were anti-VEGF-naïve. Contrast-enhancing tumor segmentations were used to extract: the lowest peak of the double gaussian distribution of apparent diffusion coefficient values (ADC L ) calculated from diffusion MRI, relative cerebral blood flow (rCBV) values from perfusion MRI, MTR asym @ 3ppm from pH-weighted amine CEST MRI, quantitative T 2 and T 2 * relaxation times (qT 2 and qT 2 *), T 1 w subtraction map values, and contrast-enhancing tumor volume. Lesions were categorized as high- or low-ADC L using a cutoff of 1240 µm 2 /s, according to previous studies. Results High-ADC L lesions showed significantly lower rCBV (1.02 vs. 1.28, p = 0.0057), higher MTR asym @ 3ppm (2.36% vs. 2.10%, p = 0.0043), and higher qT 2 (114.8 ms vs. 100.9 ms, p = 0.0094), compared to low-ADC L lesions. No group differences were seen in contrast-enhancing tumor volume, T 1 w subtraction map values, and qT 2 *, nor in clinical variables such as sex category, MGMT status, and EGFR status. Finally, no clear group-specific preferential locations were seen. Conclusion Post-chemoradiation glioblastomas with a diffusion MRI phenotype that is known to predict a favorable response to anti-VEGF (ADC L ≥1240 µm 2 /s) have distinct biological features, with different perfusion and metabolic characteristics, and T 2 relaxation times.","journal":"Journal of Neuro-Oncology","year":2025,"id":543753,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9424,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1434066,"name":"Irina Kryukov","orcid":null,"position":1,"is_corresponding":false},{"id":396762,"name":"Jingwen Yao","orcid":"0000-0002-8828-1841","position":2,"is_corresponding":false},{"id":1230466,"name":"Ashley Teraishi","orcid":"0009-0004-3442-8109","position":3,"is_corresponding":false},{"id":396763,"name":"Catalina Raymond","orcid":"0000-0003-2757-439X","position":4,"is_corresponding":false},{"id":1434067,"name":"John Gao","orcid":null,"position":5,"is_corresponding":false},{"id":1434068,"name":"Cole Miller","orcid":null,"position":6,"is_corresponding":false},{"id":396768,"name":"Phioanh L. Nghiemphu","orcid":"0000-0003-4064-6079","position":7,"is_corresponding":false},{"id":297478,"name":"Albert Lai","orcid":"0000-0002-7265-2986","position":8,"is_corresponding":false},{"id":87673,"name":"Linda M. Liau","orcid":"0000-0002-4053-0052","position":9,"is_corresponding":false},{"id":396760,"name":"Kunal Patel","orcid":"0000-0002-9854-9178","position":10,"is_corresponding":false},{"id":396761,"name":"Richard G. Everson","orcid":"0000-0003-2809-3061","position":11,"is_corresponding":false},{"id":440286,"name":"Blaine S.C. Eldred","orcid":"0000-0002-3351-3895","position":12,"is_corresponding":false},{"id":275829,"name":"Robert M. Prins","orcid":"0000-0002-6282-6583","position":13,"is_corresponding":false},{"id":401464,"name":"David A. Nathanson","orcid":"0000-0002-4919-9159","position":14,"is_corresponding":false},{"id":397177,"name":"Noriko Salamon","orcid":"0000-0002-3520-9467","position":15,"is_corresponding":false},{"id":247467,"name":"Timothy F. Cloughesy","orcid":"0000-0002-8656-7483","position":16,"is_corresponding":false},{"id":247468,"name":"Benjamin M. Ellingson","orcid":"0000-0002-2764-6640","position":17,"is_corresponding":false},{"id":954924,"name":"Francesco Sanvito","orcid":"0000-0003-3379-9958","position":0,"is_corresponding":true}],"reference_count":57,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:53:08.338070Z","pmid":"40227555","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}