Improving Deep Learning Models for Pediatric Low-Grade Glioma Tumours Molecular Subtype Identification Using MRI-based 3D Probability Distributions of Tumour Location.

Journal: Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes
PMID:

Abstract

Pediatric low-grade gliomas (pLGG) are the most common brain tumour in children, and the molecular diagnosis of pLGG enables targeted treatment. We use MRI-based Convolutional Neural Networks (CNNs) for molecular subtype identification of pLGG and augment the models using tumour location probability maps. MRI FLAIR sequences of 214 patients (110 male, mean age of 8.54 years, 143 BRAF fused and 71 BRAF V600E mutated pLGG tumours) from January 2000 to December 2018 were included in this retrospective REB-approved study. Tumour segmentations (volumes of interest-VOIs) were provided by a pediatric neuroradiology fellow and verified by a pediatric neuroradiologist. Patients were randomly split into development and test sets with an 80/20 ratio. The 3D binary VOI masks for each class in the development set were combined to derive the probability density functions of tumour location. Three pipelines for molecular diagnosis of pLGG were developed: location-based, CNN-based, and hybrid. The experiment was repeated 100 times each with different model initializations and data splits, and the Areas Under the Receiver Operating Characteristic Curve (AUROC) was calculated, and Student's -test was conducted. The location-based classifier achieved an AUROC of 77.9, 95% confidence interval (CI) (76.8, 79.0). CNN-based classifiers achieved an AUROC of 86.1, 95% CI (85.0, 87.3), while the tumour-location-guided CNNs outperformed the other classifiers with an average AUROC of 88.64, 95% CI (87.6, 89.7), which was statistically significant (-value .0018). Incorporating tumour location probability maps into CNN models led to significant improvements for molecular subtype identification of pLGG.

Authors

  • Khashayar Namdar
    Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.
  • Matthias W Wagner
    Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
  • Kareem Kudus
    Neurosciences & Mental Health Research Program, The Hospital for Sick Children, Toronto, Canada.
  • Cynthia Hawkins
    The Arthur and Sonia Labatt Brain Tumour Research Centre (U.T., C.H.), The Hospital for Sick Children, Toronto, Ontario, Canada.
  • Uri Tabori
    Institute of Medical Science (M.D.S., K.N., U.T., F.K., B.B.E.-W.), University of Toronto, Toronto, Ontario, Canada.
  • Birgit B Ertl-Wagner
    From the Department of Radiology, University of Wisconsin Madison School of Medicine and Public Health, 600 Highland Dr, Madison, WI 53792 (D.A.B., M.L.S.); Department of Radiology, New York University, New York, NY (L.M.); Department of Musculoskeletal Radiology (M.A.B.) and Institute for Technology Assessment (E.F.H.), Massachusetts General Hospital, Boston, Mass; Department of Medical Imaging, Hospital for Sick Children, University of Toronto, Toronto, Canada (B.B.E.W.); Department of Radiology, University of California-San Diego, San Diego, Calif (K.J.F.); Department of Cancer Imaging, Division of Imaging Sciences & Biomedical Engineering, Kings College London, London, England (V.J.G.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (C.P.H.); and Department of Radiology and Radiologic Science, The Johns Hopkins University School of Medicine, Baltimore, Md (C.R.W.).
  • Farzad Khalvati
    Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada. farzad.khalvati@utoronto.ca.