Early GBM recurrence: the influence of peri-lesional oedema and the disconnectome

Motivation: Recent evidence suggests that, in glioblastoma, an 'immune cold' margin may lie within areas of oedema, influencing treatment resistance and early tumour recurrence. Goal(s): To identify features of the perilesional oedema associated with early tumour recurrence and the corresponding anatomical localization. Approach: In the largest investigation of glioma patients (n=4908), we investigate the influence of the disconnectome, which describes the estimate of disconnections which occur when lesions interrupt normal water matter connectivity, on glioblastoma recurrence. Results: We identify radiomic features of perilesional oedema and disconnectome, that influence time to early tumour recurrence; recurrence less than 6 months from completion of radical radiotherapy. Impact: Identification of features in the peri-lesional oedema and disconnectome associated with early tumour recurrence will enable precision treatment planning and personalised imaging surveillance in glioblastomas.