Identification of Prognostic Imaging Biomarkers in H3 K27-Altered Diffuse Midline Gliomas in Adults: Impact of Tumor Oxygenation Biomarkers

Motivation: The prognostic markers of H3 K27-altered diffuse midline gliomas (DMGs) in adults have yet to be studied. Goal(s): To investigate prognostic markers for H3 K27-altered DMGs in adults, including clinical, qualitative, quantitative imaging phenotypes, and tumor oxygenation characteristics. Approach: Clinical, qualitative, and quantitative imaging phenotypes were analyzed in 32 adults with H3 K27-altered DMGs. Cox analyses were conducted to determine predictors of overall survival in entire patients with H3 K27-altered DMG and subgroup of contrast-enhancing (CE) tumor. Results: The presence of LM and higher rCMRO2 of CE tumor were independently associated with poor prognosis in adult patients with H3 K27-altered DMG. Impact: Tumor oxygenation imaging biomarkers may provide valuable insight into the prognosis of H3 K27-altered diffuse midline gliomas, potentially reflecting higher metabolic activity in the tumor microenvironment.