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

Journal: Scientific reports
Published Date:

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.

Authors

  • P Rauch
    Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
  • H Stefanits
    Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria. harald.stefanits@kepleruniklinikum.at.
  • M Aichholzer
    Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
  • C Serra
    Department of Neurosurgery, Clinical Neuroscience Center, University Hospital, University of Zurich, Zurich, Switzerland.
  • D Vorhauer
    Institute of Statistics, Johannes Kepler University, Linz, Austria.
  • H Wagner
    Institute of Statistics, Johannes Kepler University, Linz, Austria.
  • P Böhm
    Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
  • S Hartl
    Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
  • I Manakov
    ImFusion GmbH, Munich, Germany.
  • M Sonnberger
    Institute of Neuroradiology, Kepler University Hospital and Johannes Kepler University, Linz, Austria.
  • E Buckwar
    Institute of Stochastics, Johannes Kepler University, Linz, Austria.
  • F Ruiz-Navarro
    Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
  • K Heil
    Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
  • M Glöckel
    Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
  • J Oberndorfer
    Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
  • S Spiegl-Kreinecker
    Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
  • K Aufschnaiter-Hiessböck
    Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
  • S Weis
    Institute of Neuroscience and Medicine (INM-7 Brain and Behaviour), Forschungszentrum Jülich, Jülich, Germany.
  • A Leibetseder
    Department of Neurology, Kepler University Hospital and Johannes Kepler University, Linz, Austria.
  • W Thomae
    Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
  • T Hauser
    Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
  • C Auer
    Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
  • S Katletz
    Department of Neurology, Kepler University Hospital and Johannes Kepler University, Linz, Austria.
  • A Gruber
    Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
  • M Gmeiner
    Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.