Sex Differences in MRI-Based Metrics of Glioma Invasion and Brain Mechanics

Gliomas are brain tumors characterized by highly variable growth patterns. Magnetic resonance imaging (MRI) is the cornerstone of glioma diagnosis and management planning. However, glioma features on MRI do not directly correlate with tumor cell distribution. Additionally, there is evidence that glioma tumor characteristics and prognosis are sex-dependent. Magnetic resonance elastography (MRE) is an imaging technique that allows interrogation of tissue stiffness in-vivo and has found utility in the imaging of several cancers. We investigate the relationship between MRI features, MRE features, and growth parameters derived from an established mathematical model of glioma proliferation and invasion. Results suggest that both the relationship between tumor volume and tumor stiffness as well as the relationship between the parameters derived from the mathematical model and tumor stiffness are sex-dependent. These findings lend evidence to a growing body of knowledge about the clinical importance of sex in the context of cancer diagnosis, prognosis and treatment. ### Competing Interest Statement The authors have declared no competing interest. * Abbreviations : HGG : high grade gliomas T1Gd : T1-weighted gadolinium contrasted T2-FLAIR : T2 weighted fluid attenuated inversion recovery ROI : region of interest CC : contralateral control CE : contrast enhancing MRI : magnetic resonance imaging; MRE : magnetic resonance elastography; MNO : Mathematical Neuro-Oncology Lab; PNT : Precision Neurotherapeutics Innovation Program D : tumor diffusiveness ρ : tumor proliferation D/ρ : tumor invasiveness