Predicting glioma survival and extracellular matrix remodeling through MRI radiogenomics.

Extracellular matrix (ECM) remodeling is essential for glioma invasion, yet lacks non-invasive assessment methods. This study employs radiogenomics to enable non-invasive survival prediction and ECM remodeling assessment in glioma. Utilizing a multi-dataset data (n = 891), an 11-feature radiomics signature is developed stratifying patients into low- and high-Rad-score groups (area under the receiver operator characteristic curve [AUC] = 0.886, 95% confidence interval [CI]: 0.807-0.964 in the training set from two local centers; AUC = 0.828, 95% CI: 0.796-0.893 in the validation set from five public datasets). Radiogenomic analysis (n = 572) reveals differentially expressed genes significantly associated with Rad-scores, particularly enriched in pathways associated with ECM remodeling, and identifies seven related hub genes (MMP2, MMP9, CXCL8, TIMP1, IL-6, COL1A2, and CCL2). These findings are validated using an external radiogenomic dataset and orthotopic (both syngeneic and xenograft) mouse models, where silencing MMP2 reduced Rad-scores and tumor infiltration. This study highlights the potential of MRI-based radiomics signatures in assessing ECM remodeling for survival prediction and improved glioma clinical management.