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Background To investigate the influence of different MRI features on survival in patients with medulloblastoma. Methods A total of 171 patients were included in the study, including 131 pediatric and 40 adults (&amp;gt; 18 years). A set of 16 pre-defined semantic MRI features was analyzed using T1W (pre and post-contrast), T2W, and diffusion-weighted imaging (additional sequences as available). Patients with a definitive event (recurrence) or a minimum follow up of 12 months (in case of no recurrence) were included in the current analysis. All patients were treated and followed up according to standard institutional practice. Log-rank test was used for univariate analysis (UVA) and Cox regression for multivariate analysis (MVA). Results The molecular subgroups were as follows: WNT-27 children, 7 adults; SHH-31 children, 29 adults; group 3–32 children, 3 adults; and group 4–41 children, 1 adult. The median follow up was 45 months (range 1 to 137 months). For all the patients, on UVA the recurrence-free survival (RFS) was significantly (p&amp;lt;0.05) influenced by location-vertical, brainstem involvement, contrast uptake area, contrast heterogeneity, necrosis, and calcification. Similar factors (T2W homogeneity instead of area of contrast) impacted overall survival (OS). On MVA, location-vertical, brainstem involvement, and calcification were significant features for both RFS and OS. Tumor location-vertical was the only feature influencing RFS and OS within the SHH subgroup. For group 3 tumors, contrast uptake area (RFS and OS) and calcification (RFS alone) had a significant influence (MVA). Within group 4, contrast pattern (RFS) and T2W homogeneity (RFS and OS) were significant factors on UVA, none on MVA. Conclusion Several MRI features can be linked with survival in patients with medulloblastoma, with a specific impact on individual molecular subgroups. Considering the entire population, non-central location on the vertical aspect, tumors away from brainstem, calcification are risk factors associated with inferior outcomes.

EMBR-14. INFLUENCE OF MRI FEATURES ON THE SURVIVAL AND IMPACT ON INDIVIDUAL MOLECULAR SUBGROUPS: RESULT FROM 171 PATIENTS WITH MEDULLOBLASTOMA