A Multi-parametric MRI-Based Radiomics Signature and a Practical ML Model for Stratifying Glioblastoma Patients Based on Survival Toward Precision Oncology

Abstract

Purpose: Predicting patients' survival outcomes is recognized of key importance to clinicians in oncology toward determining an ideal course of treatment and patient management. This study applies radiomics analysis on pre-operative multi-parametric MRI of patients with glioblastoma from multiple institutions to identify a signature and a practical machine learning model for stratifying patients into groups based on overall survival. Methods: This study included 163 patients' data with glioblastoma, collected by BRATS 2018 Challenge from multiple institutions. In this proposed method, a set of 147 radiomics image features were extracted locally from three tumor sub-regions on standardized pre-operative multi-parametric MR images. LASSO regression was applied for identifying an informative subset of chosen features whereas a Cox model used to obtain the coefficients of those selected features. Then, a radiomics signature model of 9 features was constructed on the discovery set and it performance was evaluated for patients stratification into short- (<10 months), medium- (10–15 months), and long-survivors (>15 months) groups. Eight ML classification models, trained and then cross-validated, were tested to assess a range of survival prediction performance as a function of the choice of features. Results: The proposed mpMRI radiomics signature model had a statistically significant association with survival ( P < 0.001) in the training set, but was not confirmed ( P = 0.110) in the validation cohort. Its performance in the validation set had a sensitivity of 0.476 (short-), 0.231 (medium-), and 0.600 (long-survivors), and specificity of 0.667 (short-), 0.732 (medium-), and 0.794 (long-survivors). Among the tested ML classifiers, the ensemble learning model's results showed superior performance in predicting the survival classes, with an overall accuracy of 57.8% and AUC of 0.81 for short-, 0.47 for medium-, and 0.72 for long-survivors using the LASSO selected features combined with clinical factors. Conclusion: A derived GLCM feature, representing intra-tumoral inhomogeneity, was found to have a high association with survival. Clinical factors, when added to the radiomics image features, boosted the performance of the ML classification model in predicting individual glioblastoma patient's survival prognosis, which can improve prognostic quality a further step toward precision oncology.

Glioblastoma and primary central nervous system lymphoma: differentiation using MRI derived first-order texture analysis – a machine learning study

“…LASSO is commonly used to reduce data collinearity when the number of features exceed the sample size. 17 Correlation filter is a type of feature selection method in which feature selection is independent of the model construction process. The filter removes highly correlated features that may only provide redundant information.…”

Overall Survival Prediction in Glioblastoma With Radiomic Features Using Machine Learning

“…Osman et al extracted a set of 147 radiomic image features locally from three tumor subregions on standardized preoperative multiparametric MR images. LASSO regression was applied for identifying an informative subset of chosen features, whereas a Cox model was used to obtain the coefficients of those selected features (Osman, 2019 ). Despite the various correlations between imaging features, genomic expression, and survival reported in the literature, no single analysis has been substantive enough to enter clinical practice.…”

Utility of Radiomics for Predicting Patient Survival in Hepatocellular Carcinoma With Portal Vein Tumor Thrombosis Treated With Stereotactic Body Radiotherapy

“…The application of radiomics has been extensively studied in esophageal cancer ( 28 , 29 ), non-small cell lung cancer ( 30 ), breast cancer ( 31 ), nasopharyngeal carcinoma ( 32 ), Glioblastoma ( 33 ), and rectal cancer ( 34 ), which indicates the potential of radiomics for predicting the efficacy of treatment or patient prognosis. Radiotherapy-orientated CT imaging must be acquired prior to SBRT treatment of HCC with PVTT.…”