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Radiomics in peritumoral non-enhancing regions: fractional anisotropy and cerebral blood volume improve prediction of local progression and overall survival in patients with glioblastoma

  • Diagnostic Neuroradiology
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Abstract

Purpose

The peritumoral non-enhancing region (NER) is frequently not removed during the surgical resection of glioblastoma, with most recurrences occurring within the original treatment field. This study determined whether radiomics analysis of the NER can predict local recurrence and overall survival in patients with glioblastoma.

Methods

Preoperative magnetic resonance imaging (MRI) scans from 83 consecutive patients with glioblastoma were retrospectively reviewed and grouped into training (n = 59) and test sets (n = 24). A total of 6472 radiomic features were extracted from contrast-enhanced T1-weighted and fluid-attenuated inversion recovery images and from fractional anisotropy (FA) and normalized cerebral blood volume (CBV) maps. A diagnostic model to predict 6-month progression was tested using the area under the receiver operating characteristics curve (AUC) and compared with the single parameters of FA and CBV. A survival model was tested using Harrell’s C-index and compared with clinical models that included age, sex, Karnofsky performance score, and extent of surgical resection.

Results

Four FA features and six CBV features were selected for the diagnostic model; no features were extracted from conventional MRI. Combined FA and CBV radiomics showed better predictive value for local progression (AUC, 0.79; 95% CI, 0.67–0.90) than single imaging radiomics (AUC, 0.70–0.76) or single imaging parameters (AUC, 0.51–0.54). The combined model (C-index, 0.87) improved prognostication when added to clinical models (C-index, 0.72).

Conclusion

Radiomics features using FA and CBV in the NER have the potential to improve prediction of local progression and overall survival in patients with glioblastoma.

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Funding

This research was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIP) (Grant no. NRF-2017R1C1B2007258) and the National R&D Program for Cancer Control, Ministry of Health and Welfare, Republic of Korea (1720030). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Author notes

  1. JYK and MJY contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, 29 Saemunan-ro, Jongro-gu, Seoul, 03181, South Korea

    Jung Youn Kim

  2. Department of Radiology, University of Konyang College of Medicine, Konyang University Hospital, Daejeon, 35365, South Korea

    Min Jae Yoon

  3. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-Gu, Seoul, 05505, South Korea

    Ji Eun Park & Ho Sung Kim

  4. Laboratory for Imaging Science and Technology, Department of Electrical and Computer Engineering, Seoul National University, Seoul, South Korea

    Eun Jung Choi & Jongho Lee

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Reference no. 2018-0003) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Kim, J.Y., Yoon, M.J., Park, J.E. et al. Radiomics in peritumoral non-enhancing regions: fractional anisotropy and cerebral blood volume improve prediction of local progression and overall survival in patients with glioblastoma. Neuroradiology 61, 1261–1272 (2019). https://doi.org/10.1007/s00234-019-02255-4

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