88 Slip Interface Imaging in Glioblastoma: A Pilot Study of Tumour-Brain Adhesion and Surgical Resectability

Vollständiger Abstract

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Abstract Background Achieving a macroscopic complete resection (CR) is a primary prognostic goal in glioblastoma multiforme (GBM) surgery, yet it is often limited by aggressive tumour infiltration at the tumour–brain interface (TBI). The mechanical quality of this interface dictates the ease of surgical dissection, but it cannot currently be assessed preoperatively. Here, we investigated Slip Interface Imaging (SII), derived from in vivo Magnetic Resonance Elastography (MRE), as a non-invasive tool to quantify TBI adhesion and predict GBM surgical resectability. Methods High-resolution MRE was performed in seven histologically-confirmed GBM patients approximately 24 hours before surgery. SII metrics were generated by measuring strain transfer across a 1-voxel TBI shell; higher values indicate mechanical coupling (adhesion), while lower values indicated a slip-prone plane (disconnected). We then quantified mean interface adhesion (i.e., ROI-averaged adhesion) and the fraction of adherent interface voxels using a pre-defined exploratory threshold of 0.1. Metrics were compared between patients who subsequently underwent partial (n = 2) or complete (n = 5) resection. Results Mean interface adhesion was higher in partial resections than in complete resections (0.161±0.04 vs 0.098±0.03). The fraction of adherent TBI voxels exceeding the threshold was greater in partial resections (72%) compared with complete resections (37%); a range of thresholds tested maintained consistent between-group ratios. Both outcomes suggest that lower measured adhesion at the TBI is associated with complete resection, whereas higher and more widespread adhesion is associated with partial resection. Conclusions Slip Interface Imaging enables voxel-wise quantification of tumour-brain mechanical integration and demonstrates sensitivity to differences in GBM surgical outcomes. These initial findings suggest that greater mechanical coupling at the TBI may correspond to increased operative complexity, supporting further investigation of mechanical mapping to aid preoperative assessment and surgical planning for GBM.