Background: Accurate prognostic models are essential for optimizing treatment strategies for glioblastoma, the most aggressive primary brain tumor. While other neuroimaging modalities have demonstrated utility in predicting overall survival (OS), intraoperative ultrasound (iUS) remains underexplored for this purpose. This study aimed to evaluate the prognostic potential of iUS radiomics in glioblastoma patients in a multi-institutional cohort. Methods: This retrospective study included patients diagnosed with glioblastoma from the multicenter Brain Tumor Intraoperative (BraTioUS) database. A single 2D iUS slice, showing the largest tumor diameter, was selected for each patient. Radiomic features were extracted and subjected to feature selection, and clinical data were collected. Using a fivefold cross-validation strategy, Cox proportional hazards models were built using radiomic features alone, clinical data alone, and their combination. Model performance was assessed via the concordance index (C-index). Results: A total of 114 patients met the inclusion criteria, with a mean age of 56.88 years, a median OS of 382 days, and a median preoperative tumor volume of 32.69 cm3. Complete tumor resection was achieved in 51.8% of the patients. In the testing cohort, the combined model achieved a mean C-index of 0.87 (95% CI: 0.76–0.98), outperforming the radiomic model (C-index: 0.72, 95% CI: 0.57–0.86) and the clinical model (C-index: 0.73, 95% CI: 0.60–0.87). Conclusions: Intraoperative ultrasound relies on acoustic properties for tissue characterization, capturing unique features of glioblastomas. This study demonstrated that radiomic features derived from this imaging modality have the potential to support the development of survival models.
背景：胶质母细胞瘤是最具侵袭性的原发性脑肿瘤，建立准确的预后模型对于优化其治疗策略至关重要。虽然其他神经影像学方法已证明可用于预测总生存期，但术中超声在此方面的应用潜力尚未得到充分探索。本研究旨在通过多中心队列评估术中超声影像组学对胶质母细胞瘤患者的预后预测价值。 方法：这项回顾性研究纳入了来自多中心脑肿瘤术中超声数据库的胶质母细胞瘤确诊患者。为每位患者选取显示最大肿瘤直径的单个二维术中超声切面。提取影像组学特征并进行特征筛选，同时收集临床数据。采用五折交叉验证策略，分别构建基于单纯影像组学特征、单纯临床数据以及两者结合的Cox比例风险模型。通过一致性指数评估模型性能。 结果：共114例患者符合纳入标准，平均年龄56.88岁，中位总生存期382天，术前中位肿瘤体积32.69 cm³。51.8%的患者实现了肿瘤完全切除。在测试队列中，联合模型获得0.87的平均一致性指数（95% CI：0.76-0.98），优于单纯影像组学模型（一致性指数：0.72，95% CI：0.57-0.86）和单纯临床模型（一致性指数：0.73，95% CI：0.60-0.87）。 结论：术中超声依赖声学特性进行组织表征，能够捕捉胶质母细胞瘤的独特特征。本研究表明，基于该成像技术提取的影像组学特征具有支持生存模型开发的潜力。
肿瘤(癌症)患者之家