Fig. 4.

A normalized metric of tumor infiltration, Sox2 density, identifies tumor outside of conventional imaging and exhibits striking correlations with sMRI biomarkers. Though no obvious abnormality can be found on preoperative T1w-CE (A) or T2w imaging (B) in this patient, a striking elevation in Cho/NAA (C) on sMRI suggests substantial tumor infiltration. (D) A light micrograph of tissue (including 200 μm scale bar) from the gold box showed elevations in Sox2 density along with the microvascular proliferation and nuclear atypia suggestive of GBM. (E) Statistically significant correlations were seen between various normalized metabolic markers and Sox2 density, with Cho/NAA exhibiting the strongest association. *Significant at P < .05. DWI-ADC, diffusion-weighted image–apparent diffusion coefficient.