MGMT Status and White Matter Tract Infiltration in Glioblastoma: A Voxel-Wise Approach to Survival Mapping

Motivation: This study is motivated by the need to understand how GBM infiltrates WM tracts, impacting patient prognosis, particularly across differing MGMT methylation statuses. Goal(s): This study aims to identify WM tracts associated with poorer survival in MGMT-positive and MGMT-negative GBM patients. Approach: This study performed voxel-wise survival analysis on the UCSF-PDGM cohort to explore the impact of WM tract involvement on prognosis within MGMT-positive and MGMT-negative patients. Results: Our findings reveal distinct WM tracts linked to poorer survival in each subgroup, emphasizing the role of MGMT status and WM tract infiltration in shaping prognosis and potential treatment strategies. Impact: Our study highlights the combined impact of white matter tract infiltration and MGMT status on GBM prognosis, highlighting pathways associated with worse survival. These findings could inform personalized treatment strategies that focus on high-risk WM tracts, enhancing patient outcomes.