Evidence map›Paper›PMID 42622898›Full record

ArticleJournal of neuro-oncology2026

Hypoxia-targeted BOLD MRI signal heterogeneity as a complementary metric for glioblastoma characterization: a pilot study.

Leonie Zerweck, Tristan Schmidlechner, Vittorio Stumpo, Elisabeth Jehli, Meltem Gönel, Flavia Müller, Jacopo Bellomo, Martina Sebök, Andrea Bink, Zsolt Kulcsár and 4 more

Abstract read
In one paragraph

Article in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Leonie ZerweckDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland. leonie.zerweck@usz.ch.ORCID http://orcid.org/0000-0003-4105-5131
Tristan SchmidlechnerDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0009-0006-0915-5983
Vittorio StumpoDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-8175-0035
Elisabeth JehliDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0001-7188-1798
Meltem GönelDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-8652-0554
Flavia MüllerDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Jacopo BellomoDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0009-0005-8945-4838
Martina SebökDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-7246-3421
Andrea BinkDepartment of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Zsolt KulcsárDepartment of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-6805-5150
Michael WellerDepartment of Neurology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-1748-174X
Luca RegliDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0003-4639-4474
Christiaan H B van NiftrikDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0003-0930-8717
Jorn FierstraDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0001-6220-0727

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeHypoxia-targeted blood oxygen level-dependent (BOLD) MRI is an emerging non-contrast imaging technique for characterizing tumor biology in isocitrate dehydrogenase-wildtype glioblastoma. Beyond the magnitude of BOLD signal changes, signal heterogeneity may provide valuable information about tumor aggressiveness and microenvironmental complexity. The aim was to assess both the magnitude and heterogeneity of hypoxia-targeted BOLD signal changes across subregions of glioblastomas.

methodsIn this prospective pilot study, hypoxia-targeted BOLD MRI data from 12 patients with histopathologically confirmed glioblastoma were analyzed. Tumor subregions were defined using an automated segmentation framework (Oncohabitats) based on conventional MRI and dynamic susceptibility contrast (DSC) MR perfusion imaging. Voxel-wise BOLD signal changes were calculated within the following volumes of interest: highly angiogenic tumor (HAT), low angiogenic tumor (LAT), peritumoral edema, and mirrored contralateral control tissue (mCET). The magnitude of BOLD signal changes was assessed using median BOLD signal changes, while heterogeneity was quantified using interquartile ranges (IQR), and kernel density estimation-derived entropy. Friedman tests with Dunn post-hoc tests were used to assess parameter differences between the VOIs.

resultsHAT demonstrated the largest BOLD signal changes compared with LAT, edema, and mCET (all FDR-adjusted p ≤ 0.017). Heterogeneity metrics revealed significantly increased IQR and entropy in HAT compared with edema and mCET (all FDR-adjusted p < 0.008), with LAT showing intermediate values.

conclusionHypoxia-targeted BOLD MRI reveals both greater BOLD signal changes and elevated intratumoral heterogeneity in highly angiogenic and likely aggressive glioblastoma subregions. These findings suggest that heterogeneity metrics may provide complementary information to BOLD signal magnitude alone.

Indexed as

Brain NeoplasmsGlioblastomaMagnetic Resonance ImagingOxygenAdultAgedFemaleHumansMaleMiddle AgedNeovascularization, PathologicPerfusion Magnetic Resonance ImagingPilot ProjectsProspective StudiesOxygenAngiogenesisBiomarkerBrain tumorMicroenvironmentOxygenation

Identifiers

PMID42622898
PMCPMC13493451

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.