A precise location comparison of SOX2 positive glioma invasion and conventional MP-MRI signatures at autopsy

Motivation: SOX2 is a marker of pluripotency that highlights tumor invasion beyond gross histological signatures, but the imaging characteristics of pluripotent tumor areas are unknown. Goal(s): Do conventional imaging signatures deliniate SOX2 positive staining tumor cell regions?Approach: This study compared imaging data from 22 glioma patients to aligned SOX2 autopsy tissue samples. Results: SOX2-positive regions were often present beyond the imaging-defined tumor mass, with a positive but not collinear association between SOX2 and cell density across most. However, MR intensity distributions did not effectively distinguish SOX2 positivity. Impact: These results highlight a novel signature of tumor presence that exists well-beyond the imaging-defined margin and is not readily detectable via conventional imaging. These areas are spared treatment and require new technological developments to detect non-invasively.