{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T23:21:32Z","timestamp":1787440892400,"version":"build-2736575974"},"reference-count":42,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:00:00Z","timestamp":1748995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Indian J Radiol Imaging"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Introduction\u2003Glioblastoma multiforme (GBM) is a highly malignant brain tumor with poor prognosis, despite maximal safe resection and chemoradiotherapy. Predicting survival outcomes is crucial for optimizing treatment strategies. While conventional magnetic resonance imaging (MRI) reveals tumor characteristics, advanced sequences like diffusion tensor imaging (DTI) and susceptibility-weighted imaging (SWI) may enhance prognostic accuracy.<\/jats:p>\n                  <jats:p>Materials and Methods\u2003A retrospective study reviewed 45 newly diagnosed GBM patients treated with maximal safe resection, adjuvant radiotherapy, and temozolomide between 2016 and 2022. Preoperative MRI data, including conventional sequences, DTI, and SWI, were analyzed. Radiological parameters\u2014tumor volume, edema:tumor volume ratio, necrosis, enhancement, fractional anisotropy (FA), and microhemorrhage\u2014were assessed for survival prediction. Kaplan\u2013Meier survival analysis and Cox regression evaluated their prognostic significance.<\/jats:p>\n                  <jats:p>Results\u2003Among the 45 patients, the median follow-up was 58.3 weeks, with 30 deaths reported. Significant differences were observed in FA, edema:tumor volume ratio, necrosis, enhancement, and microhemorrhage between survivors and nonsurvivors. Higher edema:tumor volume ratio (cutoff \u2265 0.905, area under the curve [AUC]\u2009=\u20090.895) and higher FA (cutoff \u2265 0.655, AUC\u2009=\u20090.8) correlated with mortality and survival, respectively. Multivariate Cox regression identified edema:tumor volume ratio (hazard ratio [HR]\u2009=\u20097.4, p\u2009&lt;\u20090.05) and microhemorrhage\u2009&gt;\u200925% (HR\u2009=\u200945.9, p\u2009&lt;\u20090.05) as independent predictors of mortality.<\/jats:p>\n                  <jats:p>Conclusion\u2003Tumor-related edema and necrosis significantly influence mortality, with edema:tumor volume ratio emerging as a stronger predictor than individual tumor or edema volumes. FA values reflect tumor aggressiveness, correlating with survival. Incorporating advanced imaging parameters like DTI and SWI alongside conventional MRI enhances prognostic precision in GBM management.<\/jats:p>","DOI":"10.1055\/s-0045-1807738","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:36:58Z","timestamp":1756363018000},"page":"048-058","source":"Crossref","is-referenced-by-count":1,"title":["Prediction of Survival in Surgically Treated Glioblastoma Multiforme Utilizing DTI and Contrast-Enhanced MRI"],"prefix":"10.1055","volume":"36","author":[{"given":"Akhil","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna, Bihar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2286-0701","authenticated-orcid":false,"given":"Mainak","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of General Surgery, All India Institute of Medical Sciences, Patna, Bihar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5940-9490","authenticated-orcid":false,"given":"Subhash","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna, Bihar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand K.","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences, Patna, Bihar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saraj K.","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences, Patna, Bihar India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/s00401-016-1545-1","article-title":"The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary","volume":"131","author":"D N Louis","year":"2016","journal-title":"Acta Neuropathol"},{"issue":"10","key":"ref2","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1200\/JOP.2017.025536","article-title":"Treatment of glioblastoma","volume":"13","author":"J Y Nam","year":"2017","journal-title":"J Oncol Pract"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3390\/brainsci8010015","article-title":"Glioblastoma under siege: an overview of current therapeutic strategies","volume":"8","author":"M Paolillo","year":"2018","journal-title":"Brain Sci"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"v1","DOI":"10.1093\/neuonc\/nos218","article-title":"CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005-2009","volume":"14","author":"T A Dolecek","year":"2012","journal-title":"Neuro-oncol"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1093\/neuonc\/now135","article-title":"Radiogenomics to characterize regional genetic heterogeneity in glioblastoma","volume":"19","author":"L S Hu","year":"2017","journal-title":"Neuro-oncol"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1148\/radiol.2018180200","article-title":"Radiomic MRI phenotyping of glioblastoma: improving survival prediction","volume":"289","author":"S Bae","year":"2018","journal-title":"Radiology"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"778627","DOI":"10.3389\/fonc.2021.778627","article-title":"Multiple survival outcome prediction of glioblastoma patients based on multiparametric MRI","volume":"11","author":"B Wang","year":"2021","journal-title":"Front Oncol"},{"issue":"11","key":"ref8","doi-asserted-by":"crossref","first-page":"2043","DOI":"10.3390\/diagnostics11112043","article-title":"A predictive clinical-radiomics nomogram for survival prediction of glioblastoma using MRI","volume":"11","author":"S Ammari","year":"2021","journal-title":"Diagnostics (Basel)"},{"issue":"09","key":"ref9","doi-asserted-by":"crossref","first-page":"1514","DOI":"10.3348\/kjr.2020.1433","article-title":"Prediction of prognosis in glioblastoma using radiomics features of dynamic contrast-enhanced MRI","volume":"22","author":"E Pak","year":"2021","journal-title":"Korean J Radiol"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"10353","DOI":"10.1038\/s41598-017-10649-8","article-title":"A deep learning-based radiomics model for prediction of survival in glioblastoma multiforme","volume":"7","author":"J Lao","year":"2017","journal-title":"Sci Rep"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"660","DOI":"10.18632\/oncotarget.26578","article-title":"Preoperative MRI-radiomics features improve prediction of survival in glioblastoma patients over MGMT methylation status alone","volume":"10","author":"F Tixier","year":"2019","journal-title":"Oncotarget"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"135","DOI":"10.18383\/j.tom.2018.00052","article-title":"Multiparameter MRI predictors of long-term survival in glioblastoma multiforme","volume":"5","author":"O Stringfield","year":"2019","journal-title":"Tomography"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1177\/1971400921990766","article-title":"Survival prediction in glioblastoma on post-contrast magnetic resonance imaging using filtration based first-order texture analysis: comparison of multiple machine learning models","volume":"34","author":"S Priya","year":"2021","journal-title":"Neuroradiol J"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/BF00146086","article-title":"Prognostic significance of preoperative MRI scans in glioblastoma multiforme","volume":"27","author":"M A Hammoud","year":"1996","journal-title":"J Neurooncol"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"190","DOI":"10.3171\/jns.2001.95.2.0190","article-title":"A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival","volume":"95","author":"M Lacroix","year":"2001","journal-title":"J Neurosurg"},{"issue":"10","key":"ref16","first-page":"2466","article-title":"MR imaging correlates of survival in patients with high-grade gliomas","volume":"26","author":"W B Pope","year":"2005","journal-title":"AJNR Am J Neuroradiol"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1093\/neuonc\/nos268","article-title":"Relationship of glioblastoma multiforme to the subventricular zone is associated with survival","volume":"15","author":"N F Jafri","year":"2013","journal-title":"Neuro-oncol"},{"issue":"03","key":"ref18","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s11060-009-9983-4","article-title":"Stem cell associated gene expression in glioblastoma multiforme: relationship to survival and the subventricular zone","volume":"96","author":"M Kappadakunnel","year":"2010","journal-title":"J Neurooncol"},{"issue":"01","key":"ref19","doi-asserted-by":"crossref","first-page":"61","DOI":"10.3171\/jns.2004.100.1.0061","article-title":"Cystic glioblastoma multiforme: survival outcomes in 22 cases","volume":"100","author":"M V Maldaun","year":"2004","journal-title":"J Neurosurg"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s10014-006-0195-8","article-title":"Pathological and clinical features of cystic and noncystic glioblastomas","volume":"23","author":"S Utsuki","year":"2006","journal-title":"Brain Tumor Pathol"},{"key":"ref21","volume-title":"WHO Classification of Tumours of the Central Nervous System","author":"D N Louis","year":"2016","edition":"4th ed."},{"issue":"02","key":"ref22","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/0360-3016(93)90203-8","article-title":"Influence of location and extent of surgical resection on survival of patients with glioblastoma multiforme: results of three consecutive Radiation Therapy Oncology Group (RTOG) clinical trials","volume":"26","author":"J R Simpson","year":"1993","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"10","key":"ref23","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1002\/(SICI)1097-0142(19991115)86:10<2117::AID-CNCR33>3.0.CO;2-8","article-title":"The role of tumor resection in the treatment of glioblastoma multiforme in adults","volume":"86","author":"F W Kreth","year":"1999","journal-title":"Cancer"},{"issue":"05","key":"ref24","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1097\/00006123-199711000-00004","article-title":"Quantitative imaging study of extent of surgical resection and prognosis of malignant astrocytomas","volume":"41","author":"A Kowalczuk","year":"1997","journal-title":"Neurosurgery"},{"issue":"01","key":"ref25","first-page":"45","article-title":"Early postoperative magnetic resonance imaging after resection of malignant glioma: objective evaluation of residual tumor and its influence on regrowth and prognosis","volume":"34","author":"F K Albert","year":"1994","journal-title":"Neurosurgery"},{"issue":"01","key":"ref26","doi-asserted-by":"crossref","first-page":"72","DOI":"10.3171\/jns.1999.90.1.0072","article-title":"Treatment of patients with primary glioblastoma multiforme with standard postoperative radiotherapy and radiosurgical boost: prognostic factors and long-term outcome","volume":"90","author":"D C Shrieve","year":"1999","journal-title":"J Neurosurg"},{"issue":"09","key":"ref27","doi-asserted-by":"crossref","first-page":"3129","DOI":"10.1200\/JCO.1997.15.9.3129","article-title":"Survival, prognostic factors, and therapeutic efficacy in low-grade glioma: a retrospective study in 379 patients","volume":"15","author":"K Lote","year":"1997","journal-title":"J Clin Oncol"},{"issue":"05","key":"ref28","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1016\/S0360-3016(02)03743-4","article-title":"Phase II study of high central dose Gamma Knife radiosurgery and marimastat in patients with recurrent malignant glioma","volume":"54","author":"D A Larson","year":"2002","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"01","key":"ref29","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1002\/(SICI)1522-2586(199901)9:1<53::AID-JMRI7>3.0.CO;2-2","article-title":"Usefulness of diffusion-weighted MRI with echo-planar technique in the evaluation of cellularity in gliomas","volume":"9","author":"T Sugahara","year":"1999","journal-title":"J Magn Reson Imaging"},{"issue":"03","key":"ref30","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1148\/radiol.2413051276","article-title":"Malignant astrocytic tumors: clinical importance of apparent diffusion coefficient in prediction of grade and prognosis","volume":"241","author":"S Higano","year":"2006","journal-title":"Radiology"},{"issue":"03","key":"ref31","doi-asserted-by":"crossref","first-page":"671","DOI":"10.2214\/ajr.162.3.8109520","article-title":"MR imaging of high-grade cerebral gliomas: value of diffusion-weighted echoplanar pulse sequences","volume":"162","author":"R D Tien","year":"1994","journal-title":"AJR Am J Roentgenol"},{"issue":"06","key":"ref32","first-page":"1081","article-title":"The role of diffusion-weighted imaging in patients with brain tumors","volume":"22","author":"K Kono","year":"2001","journal-title":"AJNR Am J Neuroradiol"},{"issue":"01","key":"ref33","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1148\/radiol.2241010637","article-title":"Lymphomas and high-grade astrocytomas: comparison of water diffusibility and histologic characteristics","volume":"224","author":"A C Guo","year":"2002","journal-title":"Radiology"},{"issue":"04","key":"ref34","first-page":"520","article-title":"Diffusion tensor MR imaging of high-grade cerebral gliomas","volume":"23","author":"S Sinha","year":"2002","journal-title":"AJNR Am J Neuroradiol"},{"issue":"01","key":"ref35","doi-asserted-by":"crossref","first-page":"49","DOI":"10.5732\/cjc.012.10242","article-title":"Glioma-related edema: new insight into molecular mechanisms and their clinical implications","volume":"32","author":"Z-X Lin","year":"2013","journal-title":"Chin J Cancer"},{"issue":"08","key":"ref36","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1177\/0271678X19859847","article-title":"Controversial roles for dexamethasone in glioblastoma - opportunities for novel vascular targeting therapies","volume":"39","author":"D Dubinski","year":"2019","journal-title":"J Cereb Blood Flow Metab"},{"issue":"05","key":"ref37","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.3892\/ol.2015.3639","article-title":"Peritumoral edema on magnetic resonance imaging predicts a poor clinical outcome in malignant glioma","volume":"10","author":"C-X Wu","year":"2015","journal-title":"Oncol Lett"},{"issue":"03","key":"ref38","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.neuchi.2018.02.003","article-title":"High-field intraoperative MRI in glioma surgery: a prospective study with volumetric analysis of extent of resection and functional outcome","volume":"64","author":"H A Leroy","year":"2018","journal-title":"Neurochirurgie"},{"issue":"05","key":"ref39","first-page":"5418","article-title":"Quantitative analysis of permeability for glioma grading using dynamic contrast-enhanced magnetic resonance imaging","volume":"14","author":"M Zhao","year":"2017","journal-title":"Oncol Lett"},{"issue":"11","key":"ref40","first-page":"679","article-title":"Pre-operative peritumoral edema and survival rate in glioblastoma multiforme","volume":"36","author":"S Y Liu","year":"2013","journal-title":"Onkologie"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jocn.2020.12.014","article-title":"Prognostic relevance of CSF and peri-tumoral edema volumes in glioblastoma","volume":"84","author":"N Mummareddy","year":"2021","journal-title":"J Clin Neurosci"},{"issue":"02","key":"ref42","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1007\/s11060-017-2587-5","article-title":"Volumetric quantification of glioblastoma: experiences with different measurement techniques and impact on survival","volume":"135","author":"C Henker","year":"2017","journal-title":"J Neurooncol"}],"container-title":["Indian Journal of Radiology and Imaging"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0045-1807738.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T22:32:17Z","timestamp":1787437937000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0045-1807738"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,4]]},"references-count":42,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2026,1,9]]},"published-print":{"date-parts":[[2026,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0045-1807738","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0971-3026","1998-3808"],"issn-type":[{"value":"0971-3026","type":"print"},{"value":"1998-3808","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,4]]}}}