Deep learning-assisted radiomics facilitates multimodal prognostication for personalized treatment strategies in low-grade glioma

Abstract

Determining the optimal course of treatment for low grade glioma (LGG) patients is challenging and frequently reliant on subjective judgment and limited scientific evidence. Our objective was to develop a comprehensive deep learning assisted radiomics model for assessing not only overall survival in LGG, but also the likelihood of future malignancy and glioma growth velocity. Thus, we retrospectively included 349 LGG patients to develop a prediction model using clinical, anatomical, and preoperative MRI data. Before performing radiomics analysis, a U2-model for glioma segmentation was utilized to prevent bias, yielding a mean whole tumor Dice score of 0.837. Overall survival and time to malignancy were estimated using Cox proportional hazard models. In a postoperative model, we derived a C-index of 0.82 (CI 0.79–0.86) for the training cohort over 10 years and 0.74 (Cl 0.64–0.84) for the test cohort. Preoperative models showed a C-index of 0.77 (Cl 0.73–0.82) for training and 0.67 (Cl 0.57–0.80) test sets. Our findings suggest that we can reliably predict the survival of a heterogeneous population of glioma patients in both preoperative and postoperative scenarios. Further, we demonstrate the utility of radiomics in predicting biological tumor activity, such as the time to malignancy and the LGG growth rate.

From molecular signatures to radiomics: tailoring neurooncological strategies through forecasting of glioma growth

“…To counteract potential variations arising from inter-and intrarater differences, we used a previously established U2-neural network, ensuring an unbiased collection of tumor segmentations. 15 For the feature extraction we used the widely implemented PyRadiomics package. 23 From an initial pool of 428 radiomics variables, we undertook a preselection based on the Pearson correlation as previously published.…”

“…23 From an initial pool of 428 radiomics variables, we undertook a preselection based on the Pearson correlation as previously published. 15…”

“…Radiomics, a method characterized by its capability of objectively extracting features from radiographic im-ages, has recently emerged as a very promising parameter subset with predictive value in this context. [15][16][17][18] By offering a detailed perspective of tumors, radiomics holds the potential to unveil the often overlooked characteristic of intratumoral heterogeneity, 13,19,20 which is integral for determining tumor behavior, guiding therapeutic decisions, and forecasting overall prognosis. The emphasis on objective feature extraction becomes paramount for facilitating comparative analyses in future research endeavors.…”