Pre-treatment subventricular zone perfusion asymmetry predicts vertical recurrence in glioblastoma

BACKGROUND: The subventricular zone (SVZ) has been involved in glioblastoma (GBM) progression; however, the detection of mutated cells in the SVZ via imaging remains unclear. This study aimed to identify the detection of mutated stem cells in the SVZ using dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI), which was utilized to investigate changes in the SVZ in patients with recurrent GBM after gross total resection (GTR). MATERIALS & METHODS: This study used presurgical DCE–MRI to assess 63 patients with recurrent GBM after GTR (mean age = 58 ± 14 years). Regions of interest in the ipsilesional and contralesional SVZ were identified. The volume transfer constant (Ktrans) and plasma volume fraction (Vp) values, including changes in the histograms, were assessed. RESULTS: The skewness and kurtosis of Vp values were significantly lower in ipsilesional SVZ and lateral ventricle around the caudate nucleus compared with the contralesional SVZ (p = 0.04 and 0.02, respectively). No significant difference was observed in the mean (p = 0.81 ~ 0.88) and median (p = 0.31 ~ 0.46) of the Vp values as well as Ktrans. CONCLUSION: These results indicate significantly lower skewness and kurtosis of Vp values in the ipsilesional SVZ compared with the contralesional SVZ, revealing that these Vp histogram parameters may be associated with “vertical recurrence” in GBM after GTR. ADVANCES IN KNOWLEDGE: We discovered latent DCE alteration in ipsilesional SVZ in patients with GBM recurrence after GTR.