Fig 1.
Multiparametric MRI techniques and contrasts.
Listed are the 8 different MRI sequences used in this study, along with their corresponding physiological representations. T1Gd = T1W signal increase on post-contrast imaging; FLAIR = Fluid-Attenuated Inversion Recovery; rCBV = Relative cerebral blood volume; DSC-pMRI = Dynamic susceptibility contrast perfusion MRI; EPI+C = T2*W signal loss (i.e., negative enhancement at ~5min post injection of 0.1 mmol/kg preload contrast injection); DWI = Diffusion weighted imaging; DTI = Diffusion tensor imaging; MD = Mean diffusivity (equivalent to apparent diffusion coefficient); FA = Fractional anisotropy.
Fig 2.
Illustrative example of biopsy locations annotated relative to imaging abnormalities.
Here we show an example case where 9 image-localized biopsies were acquired from a patient. (A) An example screenshot from the intraoperative neuronavigation system of a non-enhancing (NE) biopsy sample. (B) An example screenshot from the intraoperative neuronavigation system of a contrast-enhancing (CE) biopsy sample. (C) A screenshot from intraoperative navigation is shown, highlighting the translation to a full three-dimensional rendering of segmented imaging abnormalities and biopsy locations. The segmented CE (dark blue) and NE (light blue) abnormalities are shown with biopsy locations (red). (D-F) MRI planes overlaid with segmentations and biopsy locations, highlighting the representative spread of biopsy locations that we can achieve. Although only the CE and NE regions are outlined here, we collect other multiparametric MRIs as well for the patients as shown in Fig 1.
Table 1.
General schedule of events for this research study from patient identification to routine follow-up.
Patient information beyond routine follow-up can also be collected. No additional modifications are made to the standard clinical care trajectory unless the patient has another surgery.
Fig 3.
A schematic of our per-patient biopsy collection workflow.
Additionally, patients may have samples collected at subsequent surgeries [73–77].
Fig 4.
Overview of image-localized biopsy histology distribution.
(Top) Total number of surgeries with image-localized biopsies collected, broken down by grade (total of 183 surgeries). (Middle) Number of samples per surgery, broken down by grade. (Bottom) Total samples collected per grade (total of 1140 image-localized samples). Met = Metastatic brain tumor.
Fig 5.
Self-reported race (top) and ethnicity (bottom) in the patient cohort, which consists predominantly of patients reporting as white and not Hispanic/Latino.
See S2 Fig for sex-specific breakdowns.
Fig 6.
Flowchart for enrollment, starting from the number of patients (N) who were approached for the study, to surgeries (S) and total number of biopsies collected (bx), stratified by grade and tumor status.
See S3 and S4 Figs for sex-specific breakdowns. *One case included in the recurrent grade III group underwent a grade transformation.