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BACKGROUND AND PURPOSE: Isocitrate dehydrogenase (IDH) wild-type lower-grade gliomas (histologic grades II and III) with epidermal growth factor receptor (EGFR) amplification or telomerase reverse transcriptase (TERT) promoter mutation are reported to behave similar to glioblastoma. We aimed to evaluate whether MR imaging features could identify a subset of IDH wild-type lower-grade gliomas that carry molecular features of glioblastoma. MATERIALS AND METHODS:In this multi-institutional retrospective study, pathologically confirmed IDH wild-type lower-grade gliomas from 2 tertiary institutions and The Cancer Genome Atlas constituted the training set (institution 1 and The Cancer Genome Atlas, 64 patients) and the independent test set (institution 2, 57 patients). Preoperative MRIs were analyzed using the Visually AcceSAble Rembrandt Images and radiomics. The molecular glioblastoma status was determined on the basis of the presence of EGFR amplification and TERT promoter mutation. Molecular glioblastoma was present in 73.4% and 56.1% in the training and test sets, respectively. Models using clinical, Visually AcceSAble Rembrandt Images, and radiomic features were built to predict the molecular glioblastoma status in the training set; then they were validated in the test set. RESULTS:In the test set, a model using both Visually AcceSAble Rembrandt Images and radiomic features showed superior predictive performance (area under the curve ¼ 0.854) than that with only clinical features or Visually AcceSAble Rembrandt Images (areas under the curve ¼ 0.514 and 0.648, respectively; P , . 001, both). When both Visually AcceSAble Rembrandt Images and radiomics were added to clinical features, the predictive performance significantly increased (areas under the curve ¼ 0.514 versus 0.863, P , .001).CONCLUSIONS: MR imaging features integrated with machine learning classifiers may predict a subset of IDH wild-type lowergrade gliomas that carry molecular features of glioblastoma.ABBREVIATIONS: AUC ¼ area under the receiver operating characteristic curve; cIMPACT-NOW ¼ Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy; GBM ¼ glioblastoma; LASSO ¼ least absolute shrinkage and selection operator; RFE ¼ recursive feature elimination; SVM ¼ support vector machine; TCGA ¼ The Cancer Genome Atlas; VASARI ¼ Visually AcceSAble Rembrandt Images; WHO ¼ World Health Organization A mutation in the isocitrate dehydrogenase (IDH) gene is a major classifier that leads to the stratification of gliomas with significantly different survival rates among the lower-grade gliomas (World Health Organization [WHO] grades II and III) as well as glioblastomas (GBMs). 1-4 IDH wild-type tumors, which account for ,30% of the histologic grade II and III gliomas, show worse prognoses than those with the IDH mutation. 1,5,6 Previous studies have reported heterogeneous clinical outcomes among the IDH wild-type lower-grade gliomas according to a variable combination of genetic profiles. [7][8][9] Recently, the Consortium to Inform Molec...

Objective Our study aimed to evaluate the quality of radiomics studies on brain metastases based on the radiomics quality score (RQS), Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) checklist, and the Image Biomarker Standardization Initiative (IBSI) guidelines. Materials and Methods PubMed MEDLINE, and EMBASE were searched for articles on radiomics for evaluating brain metastases, published until February 2021. Of the 572 articles, 29 relevant original research articles were included and evaluated according to the RQS, TRIPOD checklist, and IBSI guidelines. Results External validation was performed in only three studies (10.3%). The median RQS was 3.0 (range, -6 to 12), with a low basic adherence rate of 50.0%. The adherence rate was low in comparison to the “gold standard” (10.3%), stating the potential clinical utility (10.3%), performing the cut-off analysis (3.4%), reporting calibration statistics (6.9%), and providing open science and data (3.4%). None of the studies involved test-retest or phantom studies, prospective studies, or cost-effectiveness analyses. The overall rate of adherence to the TRIPOD checklist was 60.3% and low for reporting title (3.4%), blind assessment of outcome (0%), description of the handling of missing data (0%), and presentation of the full prediction model (0%). The majority of studies lacked pre-processing steps, with bias-field correction, isovoxel resampling, skull stripping, and gray-level discretization performed in only six (20.7%), nine (31.0%), four (3.8%), and four (13.8%) studies, respectively. Conclusion The overall scientific and reporting quality of radiomics studies on brain metastases published during the study period was insufficient. Radiomics studies should adhere to the RQS, TRIPOD, and IBSI guidelines to facilitate the translation of radiomics into the clinical field.