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necrosis, lacunarity, analysis, fractal, gbm, article, survival, mri, patients, data, tumor, google, scholar, pubmed, necrotic, biological, nature, processes, glioblastoma, study, clinical, prognostic, performed, beijing, role, correlated, genes, table, cas, patterns, imaging, pathways, parameters, factors, tweighted, values, revealed, apoptosis, postcontrast, resection, china, signaling, cell, research, information, patient, magnetic, resonance, prognosis, tumors,

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nature portfolio gov/ij/plugins/fraclac/flhelp/introduction privacy policy post-contrast t1-weighted mri3 post-contrast t1-weighted imaging scientific research nature reviews post-contrast t1-weighted mri post-contrast t1-weighted images nature advertising national key research social media language kaplan-meier curve estimates reprints author information authors genome research 24 david online tools mitogen-activated protein kinase original author karperien–charles sturt university quantitative index development remain unclear akt/fkhrl1 pathway mediates full size image box-counting method13 facilitates semi-supervised learning algorithm tnf-mediated signaling pathway pi3k-akt signaling pathway unfavorable progression-free survival tools permissions including cell-matrix adhesion index full size table central nervous system kaplan-meier method magnetic resonance imaging poor progression-free survival contrast-enhanced abnormalities development plan rna-seq data necrosis development mediated signaling pathway quantify natural objects gene data analysis privacy tao jiang retrospectively reviewed data

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      headline:Relationship between necrotic patterns in glioblastoma and patient survival: fractal dimension and lacunarity analyses using magnetic resonance imaging
      description:Necrosis is a hallmark feature of glioblastoma (GBM). This study investigated the prognostic role of necrotic patterns in GBM using fractal dimension (FD) and lacunarity analyses of magnetic resonance imaging (MRI) data and evaluated the role of lacunarity in the biological processes leading to necrosis. We retrospectively reviewed clinical and MRI data of 95 patients with GBM. FD and lacunarity of the necrosis on MRI were calculated by fractal analysis and subjected to survival analysis. We also performed gene ontology analysis in 32 patients with available RNA-seq data. Univariate analysis revealed that FD < 1.56 and lacunarity > 0.46 significantly correlated with poor progression-free survival (p = 0.006 and p = 0.012, respectively) and overall survival (p = 0.008 and p = 0.005, respectively). Multivariate analysis revealed that both parameters were independent factors for unfavorable progression-free survival (p = 0.001 and p = 0.015, respectively) and overall survival (p = 0.002 and p = 0.007, respectively). Gene ontology analysis revealed that genes positively correlated with lacunarity were involved in the suppression of apoptosis and necrosis-associated biological processes. We demonstrate that the fractal parameters of necrosis in GBM can predict patient survival and are associated with the biological processes of tumor necrosis.
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