Preoperative Habitat Imaging of Intratumor Heterogeneity Using Intravoxel Incoherent Motion MRI Predicts Survival of High-Grade Gliomas

Motivation: Intratumor heterogeneity (ITH) is closely correlated with the poor prognosis of high-grade glioma (HGG). There remains a need for developing preoperative noninvasive biomarkers to assess the ITH and prognosis. Habitat imaging has shown promising potential in this regard. Goal(s): To utilize habitat analysis based on intravoxel incoherent motion (IVIM)-MRI to explore imaging markers that predict overall survival (OS) for HGG patients. Approach: Clustering voxels from IVIM-MRI parametric maps to generate spatial subregions, followed by analyzing the relationship between quantitative image features and patient survival. Results: Habitat analysis derived from IVIM-MRI is an effective tool for predicting the prognosis of HGG patients. Impact: Preoperative perfusion and diffusion heterogeneity identified by habitat analysis from IVIM-MRI were associated with the OS of HGG patients. The specific tumor subregion with prognostic value may help to refine the understanding of glioma ITH and contribute to future treatments.