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Huang YR, Fan HQ, Kuang YY, Wang P, Lu S. The Relationship Between the Molecular Phenotypes of Brain Gliomas and the Imaging Features and Sensitivity of Radiotherapy and Chemotherapy. Clin Oncol (R Coll Radiol) 2024:S0936-6555(24)00180-8. [PMID: 38821723 DOI: 10.1016/j.clon.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/28/2024] [Accepted: 05/10/2024] [Indexed: 06/02/2024]
Abstract
Gliomas are the most common primary malignant tumors of the brain, accounting for about 80% of all central nervous system malignancies. With the development of molecular biology, the molecular phenotypes of gliomas have been shown to be closely related to the process of diagnosis and treatment. The molecular phenotype of glioma also plays an important role in guiding treatment plans and evaluating treatment effects and prognosis. However, due to the heterogeneity of the tumors and the trauma associated with the surgical removal of tumor tissue, the application of molecular phenotyping in glioma is limited. With the development of imaging technology, functional magnetic resonance imaging (MRI) can provide structural and function information about tumors in a noninvasive and radiation-free manner. MRI is very important for the diagnosis of intracranial lesions. In recent years, with the development of the technology for tumor molecular diagnosis and imaging, the use of molecular phenotype information and imaging procedures to evaluate the treatment outcome of tumors has become a hot topic. By reviewing the related literature on glioma treatment and molecular typing that has been published in the past 20 years, and referring to the latest 2020 NCCN treatment guidelines, summarizing the imaging characteristic and sensitivity of radiotherapy and chemotherapy of different molecular phenotypes of glioma. In this article, we briefly review the imaging characteristics of different molecular phenotypes in gliomas and their relationship with radiosensitivity and chemosensitivity of gliomas.
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Affiliation(s)
- Y-R Huang
- Department of Radiation Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - H-Q Fan
- Department of Radiation Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Y-Y Kuang
- Department of Radiation Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - P Wang
- Department of Radiation Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - S Lu
- Department of Radiation Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China.
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Liang Q, Jing H, Shao Y, Wang Y, Zhang H. Artificial Intelligence Imaging for Predicting High-risk Molecular Markers of Gliomas. Clin Neuroradiol 2024; 34:33-43. [PMID: 38277059 DOI: 10.1007/s00062-023-01375-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024]
Abstract
Gliomas, the most prevalent primary malignant tumors of the central nervous system, present significant challenges in diagnosis and prognosis. The fifth edition of the World Health Organization Classification of Tumors of the Central Nervous System (WHO CNS5) published in 2021, has emphasized the role of high-risk molecular markers in gliomas. These markers are crucial for enhancing glioma grading and influencing survival and prognosis. Noninvasive prediction of these high-risk molecular markers is vital. Genetic testing after biopsy, the current standard for determining molecular type, is invasive and time-consuming. Magnetic resonance imaging (MRI) offers a non-invasive alternative, providing structural and functional insights into gliomas. Advanced MRI methods can potentially reflect the pathological characteristics associated with glioma molecular markers; however, they struggle to fully represent gliomas' high heterogeneity. Artificial intelligence (AI) imaging, capable of processing vast medical image datasets, can extract critical molecular information. AI imaging thus emerges as a noninvasive and efficient method for identifying high-risk molecular markers in gliomas, a recent focus of research. This review presents a comprehensive analysis of AI imaging's role in predicting glioma high-risk molecular markers, highlighting challenges and future directions.
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Affiliation(s)
- Qian Liang
- Department of Radiology, First Hospital of Shanxi Medical University, 030001, Taiyuan, Shanxi Province, China
- College of Medical Imaging, Shanxi Medical University, 030001, Taiyuan, Shanxi Province, China
| | - Hui Jing
- Department of MRI, The Sixth Hospital, Shanxi Medical University, 030008, Taiyuan, Shanxi Province, China
| | - Yingbo Shao
- Department of Radiology, First Hospital of Shanxi Medical University, 030001, Taiyuan, Shanxi Province, China
- College of Medical Imaging, Shanxi Medical University, 030001, Taiyuan, Shanxi Province, China
| | - Yinhua Wang
- Department of Radiology, First Hospital of Shanxi Medical University, 030001, Taiyuan, Shanxi Province, China
- College of Medical Imaging, Shanxi Medical University, 030001, Taiyuan, Shanxi Province, China
| | - Hui Zhang
- Department of Radiology, First Hospital of Shanxi Medical University, 030001, Taiyuan, Shanxi Province, China.
- College of Medical Imaging, Shanxi Medical University, 030001, Taiyuan, Shanxi Province, China.
- Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, 030001, Taiyuan, Shanxi Province, China.
- Intelligent Imaging Big Data and Functional Nano-imaging Engineering Research Center of Shanxi Province, First Hospital of Shanxi Medical University, 030001, Taiyuan, Shanxi Province, China.
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Zhang H, Zhou B, Zhang H, Zhang Y, Lei Y, Huang B. Peritumoral Radiomics for Identification of Telomerase Reverse Transcriptase Promoter Mutation in Patients With Glioblastoma Based on Preoperative MRI. Can Assoc Radiol J 2024; 75:143-152. [PMID: 37552107 DOI: 10.1177/08465371231183309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Purpose: To evaluate the value of intra- and peritumoral deep learning (DL) features based on multi-parametric magnetic resonance imaging (MRI) for identifying telomerase reverse transcriptase (TERT) promoter mutation in glioblastoma (GBM). Methods: In this study, we included 229 patients with GBM who underwent preoperative MRI in two hospitals between November 2016 and September 2022. We used four 2D Convolutional Neural Networks (GoogLeNet, DenseNet121, VGG16, and MobileNetV3-Large) to extract intra- and peritumoral DL features. The Mann-Whitney U test, Pearson correlation analysis, least absolute shrinkage and selection operator, and logistic regression analysis were used for feature selection and construction of DL radiomics (DLR) signatures in different regions. These multi-parametric and multi-region signatures were combined to identify TERT promoter mutation. The area under the receiver operating characteristic curve (AUC) was used to evaluate the effects of the signatures. Results: The signatures based on the DL features from the peritumoral regions with expansion distances of 2 mm, 8 mm, and 10 mm using the GoogLeNet architecture correlated with the optimal AUC values (test set: .823, .753, and .768) in the T2-weighted, T1-weighted contrast-enhanced, and T1-weighted images. Using the stacking fusion method, DLR with multi-parameter and multi-region fusion achieved the best discrimination with AUC values of .948 and .902 in the training and test sets, respectively. Conclusions: The radiomics model based on the fusion of multi-parameter MRI intra- and peritumoral DLR signatures may help to identify TERT promoter mutation in patients with GBM.
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Affiliation(s)
- Hongbo Zhang
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Beibei Zhou
- Department of Radiology, The Seventh Affiliated Hospital Sun Yat-sen University, Shenzhen, China
| | - Hanwen Zhang
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Yuze Zhang
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yi Lei
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Biao Huang
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
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Buz-Yalug B, Turhan G, Cetin AI, Dindar SS, Danyeli AE, Yakicier C, Pamir MN, Özduman K, Dincer A, Ozturk-Isik E. Identification of IDH and TERTp mutations using dynamic susceptibility contrast MRI with deep learning in 162 gliomas. Eur J Radiol 2024; 170:111257. [PMID: 38134710 DOI: 10.1016/j.ejrad.2023.111257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/21/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023]
Abstract
PURPOSE Isocitrate dehydrogenase (IDH) and telomerase reverse transcriptase gene promoter (TERTp) mutations play crucial roles in glioma biology. Such genetic information is typically obtained invasively from excised tumor tissue; however, these mutations need to be identified preoperatively for better treatment planning. The relative cerebral blood volume (rCBV) information derived from dynamic susceptibility contrast MRI (DSC-MRI) has been demonstrated to correlate with tumor vascularity, functionality, and biology, and might provide some information about the genetic alterations in gliomas before surgery. Therefore, this study aims to predict IDH and TERTp mutational subgroups in gliomas using deep learning applied to rCBV images. METHOD After the generation of rCBV images from DSC-MRI data, classical machine learning algorithms were applied to the features obtained from the segmented tumor volumes to classify IDH and TERTp mutation subgroups. Furthermore, pre-trained convolutional neural networks (CNNs) and CNNs enhanced with attention gates were trained using rCBV images or a combination of rCBV and anatomical images to classify the mutational subgroups. RESULTS The best accuracies obtained with classical machine learning algorithms were 83 %, 68 %, and 76 % for the identification of IDH mutational, TERTp mutational, and TERTp-only subgroups, respectively. On the other hand, the best-performing CNN model achieved 88 % accuracy (86 % sensitivity, 91 % specificity) for the IDH-mutational subgroups, 70 % accuracy (73 % sensitivity and 67 % specificity) for the TERTp-mutational subgroups, and 84 % accuracy (86 % sensitivity, 81 % specificity) for the TERTp-only subgroup using attention gates. CONCLUSIONS DSC-MRI can be utilized to noninvasively classify IDH- and TERTp-based molecular subgroups of gliomas, facilitating preoperative identification of these genetic alterations.
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Affiliation(s)
- Buse Buz-Yalug
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Gulce Turhan
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Ayse Irem Cetin
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Sukru Samet Dindar
- Electrical and Electronics Engineering Department, Bogazici University, Istanbul, Turkey
| | - Ayca Ersen Danyeli
- Department of Medical Pathology, Acibadem University, Istanbul, Turkey; Center for Neuroradiological Applications and Research, Acibadem University, Istanbul, Turkey
| | - Cengiz Yakicier
- Department of Molecular Biology and Genetics, Acibadem University, Istanbul, Turkey
| | - M Necmettin Pamir
- Center for Neuroradiological Applications and Research, Acibadem University, Istanbul, Turkey; Department of Neurosurgery, Acibadem University, Istanbul, Turkey
| | - Koray Özduman
- Center for Neuroradiological Applications and Research, Acibadem University, Istanbul, Turkey; Department of Neurosurgery, Acibadem University, Istanbul, Turkey
| | - Alp Dincer
- Center for Neuroradiological Applications and Research, Acibadem University, Istanbul, Turkey; Department of Radiology, Acıbadem University, Istanbul, Turkey
| | - Esin Ozturk-Isik
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey; Center for Neuroradiological Applications and Research, Acibadem University, Istanbul, Turkey.
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Lost J, Verma T, Jekel L, von Reppert M, Tillmanns N, Merkaj S, Petersen GC, Bahar R, Gordem A, Haider MA, Subramanian H, Brim W, Ikuta I, Omuro A, Conte GM, Marquez-Nostra BV, Avesta A, Bousabarah K, Nabavizadeh A, Kazerooni AF, Aneja S, Bakas S, Lin M, Sabel M, Aboian M. Systematic Literature Review of Machine Learning Algorithms Using Pretherapy Radiologic Imaging for Glioma Molecular Subtype Prediction. AJNR Am J Neuroradiol 2023; 44:1126-1134. [PMID: 37770204 PMCID: PMC10549943 DOI: 10.3174/ajnr.a8000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/01/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND The molecular profile of gliomas is a prognostic indicator for survival, driving clinical decision-making for treatment. Pathology-based molecular diagnosis is challenging because of the invasiveness of the procedure, exclusion from neoadjuvant therapy options, and the heterogeneous nature of the tumor. PURPOSE We performed a systematic review of algorithms that predict molecular subtypes of gliomas from MR Imaging. DATA SOURCES Data sources were Ovid Embase, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science. STUDY SELECTION Per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 12,318 abstracts were screened and 1323 underwent full-text review, with 85 articles meeting the inclusion criteria. DATA ANALYSIS We compared prediction results from different machine learning approaches for predicting molecular subtypes of gliomas. Bias analysis was conducted for each study, following the Prediction model Risk Of Bias Assessment Tool (PROBAST) guidelines. DATA SYNTHESIS Isocitrate dehydrogenase mutation status was reported with an area under the curve and accuracy of 0.88 and 85% in internal validation and 0.86 and 87% in limited external validation data sets, respectively. For the prediction of O6-methylguanine-DNA methyltransferase promoter methylation, the area under the curve and accuracy in internal validation data sets were 0.79 and 77%, and in limited external validation, 0.89 and 83%, respectively. PROBAST scoring demonstrated high bias in all articles. LIMITATIONS The low number of external validation and studies with incomplete data resulted in unequal data analysis. Comparing the best prediction pipelines of each study may introduce bias. CONCLUSIONS While the high area under the curve and accuracy for the prediction of molecular subtypes of gliomas are reported in internal and external validation data sets, limited use of external validation and the increased risk of bias in all articles may present obstacles for clinical translation of these techniques.
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Affiliation(s)
- Jan Lost
- From the Department of Radiology and Biomedical Imaging (J.L., T.V., L.J., M.v.R., N.T., S.M., G.C.P., R.B., A.G., M.A.H., H.S., W.B., B.V.M.-N., A.A., M.L., M.A.), Yale School of Medicine, New Haven, Connecticut
- Department of Neurosurgery (J.L., M.S.), Heinrich-Heine-University, Duesseldorf, Germany
| | - Tej Verma
- From the Department of Radiology and Biomedical Imaging (J.L., T.V., L.J., M.v.R., N.T., S.M., G.C.P., R.B., A.G., M.A.H., H.S., W.B., B.V.M.-N., A.A., M.L., M.A.), Yale School of Medicine, New Haven, Connecticut
| | - Leon Jekel
- From the Department of Radiology and Biomedical Imaging (J.L., T.V., L.J., M.v.R., N.T., S.M., G.C.P., R.B., A.G., M.A.H., H.S., W.B., B.V.M.-N., A.A., M.L., M.A.), Yale School of Medicine, New Haven, Connecticut
| | - Marc von Reppert
- From the Department of Radiology and Biomedical Imaging (J.L., T.V., L.J., M.v.R., N.T., S.M., G.C.P., R.B., A.G., M.A.H., H.S., W.B., B.V.M.-N., A.A., M.L., M.A.), Yale School of Medicine, New Haven, Connecticut
| | - Niklas Tillmanns
- From the Department of Radiology and Biomedical Imaging (J.L., T.V., L.J., M.v.R., N.T., S.M., G.C.P., R.B., A.G., M.A.H., H.S., W.B., B.V.M.-N., A.A., M.L., M.A.), Yale School of Medicine, New Haven, Connecticut
| | - Sara Merkaj
- From the Department of Radiology and Biomedical Imaging (J.L., T.V., L.J., M.v.R., N.T., S.M., G.C.P., R.B., A.G., M.A.H., H.S., W.B., B.V.M.-N., A.A., M.L., M.A.), Yale School of Medicine, New Haven, Connecticut
| | - Gabriel Cassinelli Petersen
- From the Department of Radiology and Biomedical Imaging (J.L., T.V., L.J., M.v.R., N.T., S.M., G.C.P., R.B., A.G., M.A.H., H.S., W.B., B.V.M.-N., A.A., M.L., M.A.), Yale School of Medicine, New Haven, Connecticut
| | - Ryan Bahar
- From the Department of Radiology and Biomedical Imaging (J.L., T.V., L.J., M.v.R., N.T., S.M., G.C.P., R.B., A.G., M.A.H., H.S., W.B., B.V.M.-N., A.A., M.L., M.A.), Yale School of Medicine, New Haven, Connecticut
| | - Ayyüce Gordem
- From the Department of Radiology and Biomedical Imaging (J.L., T.V., L.J., M.v.R., N.T., S.M., G.C.P., R.B., A.G., M.A.H., H.S., W.B., B.V.M.-N., A.A., M.L., M.A.), Yale School of Medicine, New Haven, Connecticut
| | - Muhammad A Haider
- From the Department of Radiology and Biomedical Imaging (J.L., T.V., L.J., M.v.R., N.T., S.M., G.C.P., R.B., A.G., M.A.H., H.S., W.B., B.V.M.-N., A.A., M.L., M.A.), Yale School of Medicine, New Haven, Connecticut
| | - Harry Subramanian
- From the Department of Radiology and Biomedical Imaging (J.L., T.V., L.J., M.v.R., N.T., S.M., G.C.P., R.B., A.G., M.A.H., H.S., W.B., B.V.M.-N., A.A., M.L., M.A.), Yale School of Medicine, New Haven, Connecticut
| | - Waverly Brim
- From the Department of Radiology and Biomedical Imaging (J.L., T.V., L.J., M.v.R., N.T., S.M., G.C.P., R.B., A.G., M.A.H., H.S., W.B., B.V.M.-N., A.A., M.L., M.A.), Yale School of Medicine, New Haven, Connecticut
| | - Ichiro Ikuta
- Department of Radiology (I.I.), Mayo Clinic Arizona, Phoenix, Arizona
| | - Antonio Omuro
- Department of Neurology and Yale Cancer Center (A.O.), Yale School of Medicine, New Haven, Connecticut
| | - Gian Marco Conte
- Department of Radiology (G.M.C.), Mayo Clinic, Rochester, Minesotta
| | - Bernadette V Marquez-Nostra
- From the Department of Radiology and Biomedical Imaging (J.L., T.V., L.J., M.v.R., N.T., S.M., G.C.P., R.B., A.G., M.A.H., H.S., W.B., B.V.M.-N., A.A., M.L., M.A.), Yale School of Medicine, New Haven, Connecticut
| | - Arman Avesta
- From the Department of Radiology and Biomedical Imaging (J.L., T.V., L.J., M.v.R., N.T., S.M., G.C.P., R.B., A.G., M.A.H., H.S., W.B., B.V.M.-N., A.A., M.L., M.A.), Yale School of Medicine, New Haven, Connecticut
| | | | - Ali Nabavizadeh
- Department of Radiology (A.N.), Perelman School of Medicine, Hospital of University of Pennsylvania, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anahita Fathi Kazerooni
- Department of Neurosurgery (A.F.K.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Neurosurgery (A.F.K.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Center for Data-Driven Discovery (A.F.K.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Sanjay Aneja
- Department of Therapeutic Radiology (S.A), Yale School of Medicine, New Haven, Connecticut
| | - Spyridon Bakas
- Center for Biomedical Image Computing and Analytics (S.B.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Richards Medical Research Laboratories (S.B.), Philadelphia, Pennsylvania
- Department of Radiology (S.B.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - MingDe Lin
- From the Department of Radiology and Biomedical Imaging (J.L., T.V., L.J., M.v.R., N.T., S.M., G.C.P., R.B., A.G., M.A.H., H.S., W.B., B.V.M.-N., A.A., M.L., M.A.), Yale School of Medicine, New Haven, Connecticut
- Visage Imaging Inc (K.B., M.L.), San Diego, California
| | - Michael Sabel
- Department of Neurosurgery (J.L., M.S.), Heinrich-Heine-University, Duesseldorf, Germany
| | - Mariam Aboian
- From the Department of Radiology and Biomedical Imaging (J.L., T.V., L.J., M.v.R., N.T., S.M., G.C.P., R.B., A.G., M.A.H., H.S., W.B., B.V.M.-N., A.A., M.L., M.A.), Yale School of Medicine, New Haven, Connecticut
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Chen L, Chen R, Li T, Tang C, Li Y, Zeng Z. Multi-parameter MRI based radiomics nomogram for predicting telomerase reverse transcriptase promoter mutation and prognosis in glioblastoma. Front Neurol 2023; 14:1266658. [PMID: 37830090 PMCID: PMC10565857 DOI: 10.3389/fneur.2023.1266658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/12/2023] [Indexed: 10/14/2023] Open
Abstract
Objective To investigate the clinical utility of multi-parameter MRI-based radiomics nomogram for predicting telomerase reverse transcriptase (TERT) promoter mutation status and prognosis in adult glioblastoma (GBM). Methods We retrospectively analyzed MRI and pathological data of 152 GBM patients. A total of 2,832 radiomics features were extracted and filtered from preoperative MRI images. A radiomics nomogram was created on the basis of radiomics signature (rad-score) and clinical traits. The performance of the nomogram in TERT mutation identification was assessed using receiver operating characteristic (ROC) curve, calibration curves, and clinical decision curves. Pathologically confirmed TERT mutations and risk score-based TERT mutations were employed to assess patient prognosis, respectively. Results The random forest (RF) algorithm outperformed the other two algorithms, yielding the best diagnostic efficacy in differentiating TERT mutations, with area under the curve (AUC) values of 0.892 (95% CI: 0.828-0.956) and 0.824 (95% CI: 0.677-0.971) in the training set and validation sets, respectively. Furthermore, the predictive power of the radiomics nomogram constructed with the rad-score and clinical variables reached 0.916 (95%CI: 0.864, 0.968) in the training set and 0.880 (95%CI: 0.743, 1) in the validation set. Calibration curve and decision curve analysis findings further uphold the clinical application value of the radiomics nomogram. The overall survival of the high-risk subgroup was significantly shorter than that of the low-risk subgroup, which was consistent with the results of the pathologically confirmed TERT mutation group. Conclusion The radiomics nomogram could non-invasively provide promising insights for predicting TERT mutations and prognosis in GBM patients with excellent identification and calibration abilities.
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Affiliation(s)
- Ling Chen
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Department of Radiology, Liuzhou Workers Hospital, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Runrong Chen
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Tao Li
- Department of Radiology, Liuzhou Workers Hospital, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Chuyun Tang
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yao Li
- Department of Neurosurgery, Liuzhou Workers Hospital, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Zisan Zeng
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Kalaroopan D, Lasocki A. MRI-based deep learning techniques for the prediction of isocitrate dehydrogenase and 1p/19q status in grade 2-4 adult gliomas. J Med Imaging Radiat Oncol 2023; 67:492-498. [PMID: 36919468 DOI: 10.1111/1754-9485.13522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/16/2023] [Indexed: 03/16/2023]
Abstract
Molecular biomarkers are becoming increasingly important in the classification of intracranial gliomas. While tissue sampling remains the gold standard, there is growing interest in the use of deep learning (DL) techniques to predict these markers. This narrative review with a systematic approach identifies and synthesises the current published data on DL techniques using conventional MRI sequences for predicting isocitrate dehydrogenase (IDH) and 1p/19q-codeletion status in World Health Organisation grade 2-4 gliomas. Three databases were searched for relevant studies. In all, 13 studies met the inclusion criteria after exclusions. Key results, limitations and discrepancies between studies were synthesised. High accuracy has been reported in some studies, but the existing literature has several limitations, including generally small cohort sizes, a paucity of studies with independent testing cohorts and a lack of studies assessing IDH and 1p/19q together. While DL shows promise as a non-invasive means of predicting glioma genotype, addressing these limitations in future research will be important for facilitating clinical translation.
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Affiliation(s)
- Dinusha Kalaroopan
- Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Arian Lasocki
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Radiology, The University of Melbourne, Melbourne, Victoria, Australia
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8
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Yuan Y, Yu Y, Chang J, Chu YH, Yu W, Hsu YC, Patrick LA, Liu M, Yue Q. Convolutional neural network to predict IDH mutation status in glioma from chemical exchange saturation transfer imaging at 7 Tesla. Front Oncol 2023; 13:1134626. [PMID: 37223677 PMCID: PMC10200907 DOI: 10.3389/fonc.2023.1134626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/14/2023] [Indexed: 05/25/2023] Open
Abstract
Background and goal Noninvasive prediction of isocitrate dehydrogenase (IDH) mutation status in glioma guides surgical strategies and individualized management. We explored the capability on preoperatively identifying IDH status of combining a convolutional neural network (CNN) and a novel imaging modality, ultra-high field 7.0 Tesla (T) chemical exchange saturation transfer (CEST) imaging. Method We enrolled 84 glioma patients of different tumor grades in this retrospective study. Amide proton transfer CEST and structural Magnetic Resonance (MR) imaging at 7T were performed preoperatively, and the tumor regions are manually segmented, leading to the "annotation" maps that offers the location and shape information of the tumors. The tumor region slices in CEST and T1 images were further cropped out as samples and combined with the annotation maps, which were inputted to a 2D CNN model for generating IDH predictions. Further comparison analysis to radiomics-based prediction methods was performed to demonstrate the crucial role of CNN for predicting IDH based on CEST and T1 images. Results A fivefold cross-validation was performed on the 84 patients and 4090 slices. We observed a model based on only CEST achieved accuracy of 74.01% ± 1.15%, and the area under the curve (AUC) of 0.8022 ± 0.0147. When using T1 image only, the prediction performances dropped to accuracy of 72.52% ± 1.12% and AUC of 0.7904 ± 0.0214, which indicates no superiority of CEST over T1. However, when we combined CEST and T1 together with the annotation maps, the performances of the CNN model were further boosted to accuracy of 82.94% ± 1.23% and AUC of 0.8868 ± 0.0055, suggesting the importance of a joint analysis of CEST and T1. Finally, using the same inputs, the CNN-based predictions achieved significantly improved performances above those from radiomics-based predictions (logistic regression and support vector machine) by 10% to 20% in all metrics. Conclusion 7T CEST and structural MRI jointly offer improved sensitivity and specificity of preoperative non-invasive imaging for the diagnosis of IDH mutation status. As the first study of CNN model on imaging acquired at ultra-high field MR, our results could demonstrate the potential of combining ultra-high-field CEST and CNN for facilitating decision-making in clinical practice. However, due to the limited cases and B1 inhomogeneities, the accuracy of this model will be improved in our further study.
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Affiliation(s)
- Yifan Yuan
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Research Units of New Technologies of Micro-Endoscopy Combination in Skull Base Surgery (2018RU008), Chinese Academy of Medical Sciences (CAMS), Shanghai, China
| | - Yang Yu
- National Center for Neurological Disorders, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Research Units of New Technologies of Micro-Endoscopy Combination in Skull Base Surgery (2018RU008), Chinese Academy of Medical Sciences (CAMS), Shanghai, China
- Department of Radiology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jun Chang
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
| | - Ying-Hua Chu
- Magnetic Resonance (MR) Collaboration, Siemens Healthineers Ltd., Shanghai, China
| | - Wenwen Yu
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Yi-Cheng Hsu
- Magnetic Resonance (MR) Collaboration, Siemens Healthineers Ltd., Shanghai, China
| | | | - Mianxin Liu
- Shanghai Artificial Intelligence Laboratory, Shanghai, China
| | - Qi Yue
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Research Units of New Technologies of Micro-Endoscopy Combination in Skull Base Surgery (2018RU008), Chinese Academy of Medical Sciences (CAMS), Shanghai, China
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9
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Anagun Y. Smart brain tumor diagnosis system utilizing deep convolutional neural networks. MULTIMEDIA TOOLS AND APPLICATIONS 2023:1-27. [PMID: 37362644 PMCID: PMC10140727 DOI: 10.1007/s11042-023-15422-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/12/2023] [Accepted: 04/18/2023] [Indexed: 06/28/2023]
Abstract
The early diagnosis of cancer is crucial to provide prompt and adequate management of the diseases. Imaging tests, in particular magnetic resonance imaging (MRI), are the first preferred method for diagnosis. However, these tests have some limitations which can cause a delay in detection and diagnosis. The use of computer-aided intelligent systems can assist physicians in diagnosis. In this study, we established a Convolutional Neural Network (CNN)-based brain tumor diagnosis system using EfficientNetv2s architecture, which was improved with the Ranger optimization and extensive pre-processing. We also compared the proposed model with state-of-the-art deep learning architectures such as ResNet18, ResNet200d, and InceptionV4 in discriminating brain tumors based on their spatial features. We achieved the best micro-average results with 99.85% test accuracy, 99.89% Area under the Curve (AUC), 98.16% precision, 98.17% recall, and 98.21% f1-score. Furthermore, the experimental results of the improved model were compared to various CNN-based architectures using key performance metrics and were shown to have a strong impact on tumor categorization. The proposed system has been experimentally evaluated with different optimizers and compared with recent CNN architectures, on both augmented and original data. The results demonstrated a convincing performance in tumor detection and diagnosis.
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Affiliation(s)
- Yildiray Anagun
- Department of Computer Engineering, Eskisehir Osmangazi University, Eskisehir, Turkey
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10
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Nishikawa T, Ohka F, Aoki K, Suzuki H, Motomura K, Yamaguchi J, Maeda S, Kibe Y, Shimizu H, Natsume A, Innan H, Saito R. Easy-to-use machine learning system for the prediction of IDH mutation and 1p/19q codeletion using MRI images of adult-type diffuse gliomas. Brain Tumor Pathol 2023; 40:85-92. [PMID: 36991274 DOI: 10.1007/s10014-023-00459-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 03/20/2023] [Indexed: 03/31/2023]
Abstract
Adult-type diffuse gliomas are divided into Astrocytoma, IDH-mutant, Oligodendroglioma, IDH-mutant and 1p/19q-codeleted and Glioblastoma, IDH-wildtype based on the IDH mutation, and 1p/19q codeletion status. To determine the treatment strategy for these tumors, pre-operative prediction of IDH mutation and 1p/19q codeletion status might be effective. Computer-aided diagnosis (CADx) systems using machine learning have been noted as innovative diagnostic methods. However, it is difficult to promote the clinical application of machine learning systems at each institute because the support of various specialists is essential. In this study, we established an easy-to-use computer-aided diagnosis system using Microsoft Azure Machine Learning Studio (MAMLS) to predict these statuses. We constructed an analysis model using 258 adult-type diffuse glioma cases from The Cancer Genome Atlas (TCGA) cohort. Using MRI T2-weighted images, the overall accuracy, sensitivity, and specificity for the prediction of IDH mutation and 1p/19q codeletion were 86.9%, 80.9%, and 92.0%, and 94.7%, 94.1%, and 95.1%, respectively. We also constructed an reliable analysis model for the prediction of IDH mutation and 1p/19q codeletion using an independent Nagoya cohort including 202 cases. These analysis models were established within 30 min. This easy-to-use CADx system might be useful for the clinical application of CADx in various institutes.
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Affiliation(s)
- Tomohide Nishikawa
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Fumiharu Ohka
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan.
| | - Kosuke Aoki
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Hiromichi Suzuki
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan
| | - Kazuya Motomura
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Junya Yamaguchi
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Sachi Maeda
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Yuji Kibe
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Hiroki Shimizu
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Atsushi Natsume
- Institutes of Innovation for Future Society, Nagoya University, Nagoya, Japan
| | - Hideki Innan
- Department of Evolutionary Studies of Biosystems, The Graduate University for Advanced Studies, Hayama, Japan
| | - Ryuta Saito
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
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11
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Krigers A, Demetz M, Moser P, Kerschbaumer J, Brawanski KR, Fritsch H, Thomé C, Freyschlag CF. Impact of GAP-43, Cx43 and actin expression on the outcome and overall survival in diffuse and anaplastic gliomas. Sci Rep 2023; 13:2024. [PMID: 36739296 PMCID: PMC9899260 DOI: 10.1038/s41598-023-29298-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/02/2023] [Indexed: 02/05/2023] Open
Abstract
Distant intercellular communication in gliomas is based on the expansion of tumor microtubuli, where actin forms cytoskeleton and GAP-43 mediates the axonal conus growth. We aimed to investigate the impact of GAP-43 and actin expression on overall survival (OS) as well as crucial prognostic factors. FFPE tissue of adult patients with diffuse and anaplastic gliomas, who underwent first surgery in our center between 2010 and 2019, were selected. GAP-43, Cx43 and actin expression was analyzed using immunohistochemistry and semi-quantitatively ranked. 118 patients with a median age of 46 years (IqR: 35-57) were evaluated. 48 (41%) presented with a diffuse glioma and 70 (59%) revealed anaplasia. Tumors with higher expression of GAP-43 (p = 0.024, HR = 1.71/rank) and actin (p < 0.001, HR = 2.28/rank) showed significantly reduced OS. IDH1 wildtype glioma demonstrated significantly more expression of all proteins: GAP-43 (p = 0.009), Cx43 (p = 0.003) and actin (p < 0.001). The same was confirmed for anaplasia (GAP-43 p = 0.028, actin p = 0.029), higher proliferation rate (GAP-43 p = 0.016, actin p = 0.038), contrast-enhancement in MRI (GAP-43 p = 0.023, actin p = 0.037) and age (GAP-43 p = 0.004, actin p < 0.001; Cx43 n.s. in all groups). The intercellular distant communication network in diffuse and anaplastic gliomas formed by actin and GAP-43 is associated with a negative impact on overall survival and with unfavorable prognostic features. Cx43 did not show relevant impact on OS.
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Affiliation(s)
- Aleksandrs Krigers
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Matthias Demetz
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Patrizia Moser
- Department of Neuropathology, University Hospital of Innsbruck, Tirol Kliniken, Austria
| | - Johannes Kerschbaumer
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Konstantin R Brawanski
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Helga Fritsch
- Department of Anatomy, Histology and Embryology, Medical University of Innsbruck, Innsbruck, Austria
| | - Claudius Thomé
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Christian F Freyschlag
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
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12
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Glioma radiogenomics and artificial intelligence: road to precision cancer medicine. Clin Radiol 2023; 78:137-149. [PMID: 36241568 DOI: 10.1016/j.crad.2022.08.138] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/19/2022] [Indexed: 01/18/2023]
Abstract
Radiogenomics refers to the study of the relationship between imaging phenotypes and gene expression patterns/molecular characteristics, which might allow improved diagnosis, decision-making, and predicting patient outcomes in the context of multiple diseases. Central nervous system (CNS) tumours contribute to significant cancer-related mortality in the present age. Although historically CNS neoplasms were classified and graded based on microscopic appearance, there was discordance between two histologically similar tumours that showed varying prognosis and behaviour, attributable to their molecular signatures. These led to the incorporation of molecular markers in the classification of CNS neoplasms. Meanwhile, advancements in imaging technology such as diffusion-based imaging (including tractography), perfusion, and spectroscopy in addition to the conventional imaging of glial neoplasms, have opened an avenue for radiogenomics. This review touches upon the schema of the current classification of gliomas, concepts behind molecular markers, and parameters that are used in radiogenomics to characterise gliomas and the role of artificial intelligence for the same. Further, the role of radiomics in the grading of brain tumours, prediction of treatment response and prognosis has been discussed. Use of automated and semi-automated tumour segmentation for radiotherapy planning and follow-up has also been discussed briefly.
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13
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Minami N, Hong D, Stevers N, Barger CJ, Radoul M, Hong C, Chen L, Kim Y, Batsios G, Gillespie AM, Pieper RO, Costello JF, Viswanath P, Ronen SM. Imaging biomarkers of TERT or GABPB1 silencing in TERT-positive glioblastoma. Neuro Oncol 2022; 24:1898-1910. [PMID: 35460557 PMCID: PMC9629440 DOI: 10.1093/neuonc/noac112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND TERT promoter mutations are observed in 80% of wild-type IDH glioblastoma (GBM). Moreover, the upstream TERT transcription factor GABPB1 was recently identified as a cancer-specific therapeutic target for tumors harboring a TERT promoter mutation. In that context, noninvasive imaging biomarkers are needed for the detection of TERT modulation. METHODS Multiple GBM models were investigated as cells and in vivo tumors and the impact of TERT silencing, either directly or by targeting GABPB1, was determined using 1H and hyperpolarized 13C magnetic resonance spectroscopy (MRS). Changes in associated metabolic enzymes were also investigated. RESULTS 1H-MRS revealed that lactate and glutathione (GSH) were the most significantly altered metabolites when either TERT or GABPB1 was silenced, and lactate and GSH levels were correlated with cellular TERT expression. Consistent with the drop in lactate, 13C-MRS showed that hyperpolarized [1-13C]lactate production from [1-13C]pyruvate was also reduced when TERT was silenced. Mechanistically, the reduction in GSH was associated with a reduction in pentose phosphate pathway flux, reduced activity of glucose-6-phosphate dehydrogenase, and reduced NADPH. The drop in lactate and hyperpolarized lactate were associated with reductions in glycolytic flux, NADH, and expression/activity of GLUT1, monocarboxylate transporters, and lactate dehydrogenase A. CONCLUSIONS Our study indicates that MRS-detectable GSH, lactate, and lactate production could serve as metabolic biomarkers of response to emerging TERT-targeted therapies for GBM with activating TERT promoter mutations. Importantly these biomarkers are readily translatable to the clinic, and thus could ultimately improve GBM patient management.
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Affiliation(s)
- Noriaki Minami
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Donghyun Hong
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Nicholas Stevers
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Carter J Barger
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Marina Radoul
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Chibo Hong
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Lee Chen
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Yaewon Kim
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Georgios Batsios
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Anne Marie Gillespie
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Russel O Pieper
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Joseph F Costello
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Pavithra Viswanath
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Sabrina M Ronen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
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14
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Wang H, Zhang S, Xing X, Yue Q, Feng W, Chen S, Zhang J, Xie D, Chen N, Liu Y. Radiomic study on preoperative multi-modal magnetic resonance images identifies IDH-mutant TERT promoter-mutant gliomas. Cancer Med 2022; 12:2524-2537. [PMID: 36176070 PMCID: PMC9939206 DOI: 10.1002/cam4.5097] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 06/20/2022] [Accepted: 07/13/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Gliomas with comutations of isocitrate dehydrogenase (IDH) genes and telomerase reverse transcriptase (TERT) gene promoter (IDHmut pTERTmut) show distinct biological features and respond to first-line treatment differently in comparison with other gliomas. This study aimed to characterize the IDHmut pTERTmut gliomas in multimodal MRI using the radiomic method and establish a precise diagnostic model identifying this group of gliomas. METHODS A total of 140 patients with untreated primary gliomas were admitted between 2016 and 2020 to West China Hospital as a discovery cohort, including 22 IDHmut pTERTmut patients. Thirty-four additional cases from a different hospital were included in the study as an independent validation cohort. A total of 3654 radiomic features were extracted from the preoperative multimodal MRI images (T1c, FLAIR, and ADC maps) and filtered in a data-driven approach. The discovery cohort was split into training and test sets by a 4:1 ratio. A diagnostic model (multilayer perceptron classifier) for detecting the IDHmut pTERTmut gliomas was trained using an automatic machine-learning algorithm named tree-based pipeline optimization tool (TPOT). The most critical radiomic features in the model were identified and visualized. RESULTS The model achieved an area under the receiver-operating curve (AUROC) of 0.971 (95% CI, 0.902-1.000), the sensitivity of 0.833 (95% CI, 0.333-1.000), and the specificity of 0.966 (95% CI, 0.931-1.000) in the test set. The area under the precision-recall curve (AUCPR) was 0.754 (95% CI, 0.572-0.833) and the F1 score was 0.833 (95% CI, 0.500-1.000). In the independent validation set, the model reached 0.952 AUROC, 0.714 sensitivity, 0.963 specificity, 0.841 AUCPR, and 0.769 F1 score. MR radiomic features of the IDHmut pTERTmut gliomas represented homogenous low-complexity texture in three modalities. CONCLUSIONS An accurate diagnostic model was constructed for detecting IDHmut pTERTmut gliomas using multimodal radiomic features. The most important features were associated with the homogenous simple texture of IDHmut pTERTmut gliomas in MRI images transformed using Laplacian of Gaussian and wavelet filters.
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Affiliation(s)
- Haoyu Wang
- Department of NeurosurgeryWest China Hospital of Sichuan UniversityChengduChina,Department of NeurosurgeryXinhua Hospital, Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Shuxin Zhang
- Department of NeurosurgeryWest China Hospital of Sichuan UniversityChengduChina,Department of Head and Neck Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Xiang Xing
- Department of NeurosurgeryWest China Hospital of Sichuan UniversityChengduChina
| | - Qiang Yue
- Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Wentao Feng
- Department of NeurosurgeryWest China Hospital of Sichuan UniversityChengduChina
| | - Siliang Chen
- Department of NeurosurgeryWest China Hospital of Sichuan UniversityChengduChina
| | - Jun Zhang
- Frontier Science Center for Disease Molecular Network, State Key Laboratory of BiotherapyWest China Hospital of Sichuan UniversityChengduChina
| | - Dan Xie
- Frontier Science Center for Disease Molecular Network, State Key Laboratory of BiotherapyWest China Hospital of Sichuan UniversityChengduChina
| | - Ni Chen
- Department of Pathology, West China HospitalSichuan UniversityChengduSichuanChina
| | - Yanhui Liu
- Department of NeurosurgeryWest China Hospital of Sichuan UniversityChengduChina
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15
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Xu J, Meng Y, Qiu K, Topatana W, Li S, Wei C, Chen T, Chen M, Ding Z, Niu G. Applications of Artificial Intelligence Based on Medical Imaging in Glioma: Current State and Future Challenges. Front Oncol 2022; 12:892056. [PMID: 35965542 PMCID: PMC9363668 DOI: 10.3389/fonc.2022.892056] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/22/2022] [Indexed: 12/24/2022] Open
Abstract
Glioma is one of the most fatal primary brain tumors, and it is well-known for its difficulty in diagnosis and management. Medical imaging techniques such as magnetic resonance imaging (MRI), positron emission tomography (PET), and spectral imaging can efficiently aid physicians in diagnosing, treating, and evaluating patients with gliomas. With the increasing clinical records and digital images, the application of artificial intelligence (AI) based on medical imaging has reduced the burden on physicians treating gliomas even further. This review will classify AI technologies and procedures used in medical imaging analysis. Additionally, we will discuss the applications of AI in glioma, including tumor segmentation and classification, prediction of genetic markers, and prediction of treatment response and prognosis, using MRI, PET, and spectral imaging. Despite the benefits of AI in clinical applications, several issues such as data management, incomprehension, safety, clinical efficacy evaluation, and ethical or legal considerations, remain to be solved. In the future, doctors and researchers should collaborate to solve these issues, with a particular emphasis on interdisciplinary teamwork.
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Affiliation(s)
- Jiaona Xu
- Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuting Meng
- Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kefan Qiu
- Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Win Topatana
- Department of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shijie Li
- Department of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chao Wei
- Department of Neurology, Affiliated Ningbo First Hospital, Ningbo, China
| | - Tianwen Chen
- Department of Neurology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Mingyu Chen
- Department of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Mingyu Chen, ; Zhongxiang Ding, ; Guozhong Niu,
| | - Zhongxiang Ding
- Department of Radiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Mingyu Chen, ; Zhongxiang Ding, ; Guozhong Niu,
| | - Guozhong Niu
- Department of Neurology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Mingyu Chen, ; Zhongxiang Ding, ; Guozhong Niu,
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16
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Liu XP, Jin X, Seyed Ahmadian S, Yang X, Tian SF, Cai YX, Chawla K, Snijders AM, Xia Y, van Diest PJ, Weiss WA, Mao JH, Li ZQ, Vogel H, Chang H. Clinical significance and molecular annotation of cellular morphometric subtypes in lower-grade gliomas discovered by machine learning. Neuro Oncol 2022; 25:68-81. [PMID: 35716369 PMCID: PMC9825346 DOI: 10.1093/neuonc/noac154] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Lower-grade gliomas (LGG) are heterogeneous diseases by clinical, histological, and molecular criteria. We aimed to personalize the diagnosis and therapy of LGG patients by developing and validating robust cellular morphometric subtypes (CMS) and to uncover the molecular signatures underlying these subtypes. METHODS Cellular morphometric biomarkers (CMBs) were identified with artificial intelligence technique from TCGA-LGG cohort. Consensus clustering was used to define CMS. Survival analysis was performed to assess the clinical impact of CMBs and CMS. A nomogram was constructed to predict 3- and 5-year overall survival (OS) of LGG patients. Tumor mutational burden (TMB) and immune cell infiltration between subtypes were analyzed using the Mann-Whitney U test. The double-blinded validation for important immunotherapy-related biomarkers was executed using immunohistochemistry (IHC). RESULTS We developed a machine learning (ML) pipeline to extract CMBs from whole-slide images of tissue histology; identifying and externally validating robust CMS of LGGs in multicenter cohorts. The subtypes had independent predicted OS across all three independent cohorts. In the TCGA-LGG cohort, patients within the poor-prognosis subtype responded poorly to primary and follow-up therapies. LGGs within the poor-prognosis subtype were characterized by high mutational burden, high frequencies of copy number alterations, and high levels of tumor-infiltrating lymphocytes and immune checkpoint genes. Higher levels of PD-1/PD-L1/CTLA-4 were confirmed by IHC staining. In addition, the subtypes learned from LGG demonstrate translational impact on glioblastoma (GBM). CONCLUSIONS We developed and validated a framework (CMS-ML) for CMS discovery in LGG associated with specific molecular alterations, immune microenvironment, prognosis, and treatment response.
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Affiliation(s)
| | | | - Saman Seyed Ahmadian
- Department of Pathology, Stanford University Medical Center, Stanford, California, USA
| | - Xu Yang
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, California, USA,Berkeley Biomedical Data Science Center, Lawrence Berkeley National Laboratory, Berkeley, California, USA,Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Su-Fang Tian
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Yu-Xiang Cai
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Kuldeep Chawla
- Berkeley Biomedical Data Science Center, Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - Antoine M Snijders
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, California, USA,Berkeley Biomedical Data Science Center, Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - Yankai Xia
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Paul J van Diest
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - William A Weiss
- Departments of Neurology, Neurological Surgery, and Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Jian-Hua Mao
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, California, USA,Berkeley Biomedical Data Science Center, Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - Zhi-Qiang Li
- Corresponding Authors: Zhi-Qiang Li, MD, PhD, Department of Neurosurgery, Zhongnan Hospital of Wuhan University, 169 East Lake Road, Wuchang District, Wuhan, Hubei 430071 China (); Hang Chang, PhD, Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA 94720, USA ()
| | | | - Hang Chang
- Corresponding Authors: Zhi-Qiang Li, MD, PhD, Department of Neurosurgery, Zhongnan Hospital of Wuhan University, 169 East Lake Road, Wuchang District, Wuhan, Hubei 430071 China (); Hang Chang, PhD, Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA 94720, USA ()
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17
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Vagvala S, Guenette JP, Jaimes C, Huang RY. Imaging diagnosis and treatment selection for brain tumors in the era of molecular therapeutics. Cancer Imaging 2022; 22:19. [PMID: 35436952 PMCID: PMC9014574 DOI: 10.1186/s40644-022-00455-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/29/2022] [Indexed: 01/12/2023] Open
Abstract
Currently, most CNS tumors require tissue sampling to discern their molecular/genomic landscape. However, growing research has shown the powerful role imaging can play in non-invasively and accurately detecting the molecular signature of these tumors. The overarching theme of this review article is to provide neuroradiologists and neurooncologists with a framework of several important molecular markers, their associated imaging features and the accuracy of those features. A particular emphasis is placed on those tumors and mutations that have specific or promising imaging correlates as well as their respective therapeutic potentials.
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Affiliation(s)
- Saivenkat Vagvala
- Division of Neuroradiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, 75 Francis St, Boston, MA, 02115, USA
| | - Jeffrey P Guenette
- Division of Neuroradiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, 75 Francis St, Boston, MA, 02115, USA
| | - Camilo Jaimes
- Division of Neuroradiology, Boston Children's, 300 Longwood Ave., 2nd floor, Main Building, Boston, MA, 02115, USA
| | - Raymond Y Huang
- Division of Neuroradiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, 75 Francis St, Boston, MA, 02115, USA.
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18
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Hrapșa I, Florian IA, Șușman S, Farcaș M, Beni L, Florian IS. External Validation of a Convolutional Neural Network for IDH Mutation Prediction. Medicina (B Aires) 2022; 58:medicina58040526. [PMID: 35454365 PMCID: PMC9025144 DOI: 10.3390/medicina58040526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/02/2022] [Accepted: 04/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: The IDH (isocitrate dehydrogenase) status represents one of the main prognosis factors for gliomas. However, determining it requires invasive procedures and specialized surgical skills. Medical imaging such as MRI is essential in glioma diagnosis and management. Lately, fields such as Radiomics and Radiogenomics emerged as pertinent prediction tools for extracting molecular information out of medical images. These fields are based on Artificial Intelligence algorithms that require external validation in order to evaluate their general performance. The aim of this study was to provide an external validation for the algorithm formulated by Yoon Choi et al. of IDH status prediction using preoperative common MRI sequences and patient age. Material and Methods: We applied Choi’s IDH status prediction algorithm on T1c, T2 and FLAIR preoperative MRI images of gliomas (grades WHO II-IV) of 21 operated adult patients from the Neurosurgery clinic of the Cluj County Emergency Clinical Hospital (CCECH), Cluj-Napoca Romania. We created a script to automate the testing process with DICOM format MRI sequences as input and IDH predicted status as output. Results: In terms of patient characteristics, the mean age was 48.6 ± 15.6; 57% were female and 43% male; 43% were IDH positive and 57% IDH negative. The proportions of WHO grades were 24%, 14% and 62% for II, III and IV, respectively. The validation test achieved a relative accuracy of 76% with 95% CI of (53%, 92%) and an Area Under the Curve (AUC) through DeLong et al. method of 0.74 with 95% CI of (0.53, 0.91) and a p of 0.021. Sensitivity and Specificity were 0.78 with 95% CI of (0.45, 0.96) and 0.75 with 95% CI of (0.47, 0.91), respectively. Conclusions: Although our results match the external test the author made on The Cancer Imaging Archive (TCIA) online dataset, performance of the algorithm on external data is still not high enough for clinical application. Radiogenomic approaches remain a high interest research field that may provide a rapid and accurate diagnosis and prognosis of patients with intracranial glioma.
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Affiliation(s)
- Iona Hrapșa
- Department of Medical Genetics, Iuliu Hațieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania;
| | - Ioan Alexandru Florian
- Department of Neurosurgery, Iuliu Hațieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania;
- Department of Neurosurgery, Emergency County Hospital, 3-5 Clinicilor Street, 400006 Cluj-Napoca, Romania;
- Correspondence:
| | - Sergiu Șușman
- Department of Morphological Sciences-Histology, Iuliu Hațieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania;
- Department of Pathology, IMOGEN Research Center, Louis Pasteur Street, 400349 Cluj-Napoca, Romania
| | - Marius Farcaș
- Department of Medical Genetics, Iuliu Hațieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania;
- Department of Genetics, IMOGEN Research Center, Louis Pasteur Street, 400349 Cluj-Napoca, Romania
| | - Lehel Beni
- Department of Neurosurgery, Emergency County Hospital, 3-5 Clinicilor Street, 400006 Cluj-Napoca, Romania;
| | - Ioan Stefan Florian
- Department of Neurosurgery, Iuliu Hațieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania;
- Department of Neurosurgery, Emergency County Hospital, 3-5 Clinicilor Street, 400006 Cluj-Napoca, Romania;
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19
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Afridi M, Jain A, Aboian M, Payabvash S. Brain Tumor Imaging: Applications of Artificial Intelligence. Semin Ultrasound CT MR 2022; 43:153-169. [PMID: 35339256 PMCID: PMC8961005 DOI: 10.1053/j.sult.2022.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Artificial intelligence has become a popular field of research with goals of integrating it into the clinical decision-making process. A growing number of predictive models are being employed utilizing machine learning that includes quantitative, computer-extracted imaging features known as radiomic features, and deep learning systems. This is especially true in brain-tumor imaging where artificial intelligence has been proposed to characterize, differentiate, and prognostication. We reviewed current literature regarding the potential uses of machine learning-based, and deep learning-based artificial intelligence in neuro-oncology as it pertains to brain tumor molecular classification, differentiation, and treatment response. While there is promising evidence supporting the use of artificial intelligence in neuro-oncology, there are still more investigations needed on a larger, multicenter scale along with a streamlined and standardized image processing workflow prior to its introduction in routine clinical decision-making protocol.
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Affiliation(s)
- Muhammad Afridi
- School of Osteopathic Medicine, Rowan University, Stratford, NJ
| | - Abhi Jain
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT
| | - Mariam Aboian
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT
| | - Seyedmehdi Payabvash
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT.
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20
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Hasanau T, Pisarev E, Kisil O, Nonoguchi N, Le Calvez-Kelm F, Zvereva M. Detection of TERT Promoter Mutations as a Prognostic Biomarker in Gliomas: Methodology, Prospects, and Advances. Biomedicines 2022; 10:728. [PMID: 35327529 PMCID: PMC8945783 DOI: 10.3390/biomedicines10030728] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/13/2022] [Accepted: 03/17/2022] [Indexed: 11/16/2022] Open
Abstract
This article reviews the existing approaches to determining the TERT promoter mutational status in patients with various tumoral diseases of the central nervous system. The operational characteristics of the most common methods and their transferability in medical practice for the selection or monitoring of personalized treatments based on the TERT status and other related molecular biomarkers in patients with the most common tumors, such as glioblastoma, oligodendroglioma, and astrocytoma, are compared. The inclusion of new molecular markers in the course of CNS clinical management requires their rapid and reliable assessment. Availability of molecular evaluation of gliomas facilitates timely decisions regarding patient follow-up with the selection of the most appropriate treatment protocols. Significant progress in the inclusion of molecular biomarkers for their subsequent clinical application has been made since 2016 when the WHO CNS classification first used molecular markers to classify gliomas. In this review, we consider the methodological approaches used to determine mutations in the promoter region of the TERT gene in tumors of the central nervous system. In addition to classical molecular genetical methods, other methods for determining TERT mutations based on mass spectrometry, magnetic resonance imaging, next-generation sequencing, and nanopore sequencing are reviewed with an assessment of advantages and disadvantages. Beyond that, noninvasive diagnostic methods based on the determination of the mutational status of the TERT promoter are discussed.
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Affiliation(s)
- Tsimur Hasanau
- Department of Chemistry, Lomonosov Moscow State University, 119991 Moscow, Russia;
| | - Eduard Pisarev
- Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, 119234 Moscow, Russia;
- Chair of Chemistry of Natural Compounds, Department of Chemistry, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Olga Kisil
- Gause Institute of New Antibiotics, 119021 Moscow, Russia;
| | - Naosuke Nonoguchi
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan;
| | - Florence Le Calvez-Kelm
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC), 69372 Lyon, France;
| | - Maria Zvereva
- Chair of Chemistry of Natural Compounds, Department of Chemistry, Lomonosov Moscow State University, 119991 Moscow, Russia
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21
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Gore S, Chougule T, Jagtap J, Saini J, Ingalhalikar M. A Review of Radiomics and Deep Predictive Modeling in Glioma Characterization. Acad Radiol 2021; 28:1599-1621. [PMID: 32660755 DOI: 10.1016/j.acra.2020.06.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/11/2020] [Accepted: 06/11/2020] [Indexed: 12/22/2022]
Abstract
Recent developments in glioma categorization based on biological genotypes and application of computational machine learning or deep learning based predictive models using multi-modal MRI biomarkers to assess these genotypes provides potential assurance for optimal and personalized treatment plans and efficacy. Artificial intelligence based quantified assessment of glioma using MRI derived hand-crafted or auto-extracted features have become crucial as genomic alterations can be associated with MRI based phenotypes. This survey integrates all the recent work carried out in state-of-the-art radiomics, and Artificial Intelligence based learning solutions related to molecular diagnosis, prognosis, and treatment monitoring with the aim to create a structured resource on radiogenomic analysis of glioma. Challenges such as inter-scanner variability, requirement of benchmark datasets, prospective validations for clinical applicability are discussed with further scope for designing optimal solutions for glioma stratification with immediate recommendations for further diagnostic decisions and personalized treatment plans for glioma patients.
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22
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Song J, Ding C, Huang Q, Luo T, Xu X, Chen Z, Li S. Deep learning predicts epidermal growth factor receptor mutation subtypes in lung adenocarcinoma. Med Phys 2021; 48:7891-7899. [PMID: 34669994 DOI: 10.1002/mp.15307] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 12/14/2022] Open
Abstract
PURPOSE This study aimed to explore the predictive ability of deep learning (DL) for the common epidermal growth factor receptor (EGFR) mutation subtypes in patients with lung adenocarcinoma. METHODS A total of 665 patients with lung adenocarcinoma (528/137) were recruited from two different institutions. In the training set, an 18-layer convolutional neural network (CNN) and fivefold cross-validation strategy were used to establish a CNN model. Subsequently, an independent external validation cohort from the other institution was used to evaluate the predictive efficacy of the CNN model. Grad-weighted class activation mapping (Grad-CAM) technology was used for the visual interpretation of the CNN model. In addition, this study also compared the prediction abilities of the radiomics and CNN models. Receiver operating characteristic (ROC) curves, accuracy and precision values, and recall and F1-score were used to evaluate the effectiveness of the CNN model and compare its performance with that of the radiomics model. RESULTS In the validation set, the micro- and macroaverage values of the area under the ROC curve of the CNN model to identify the three EGFR subtypes were 0.78 and 0.79, respectively. All evaluation indicators of the CNN model were better than those of the radiomics model. CONCLUSIONS Our study confirmed the potential of DL for predicting the EGFR mutation status in lung adenocarcinoma. The imaging phenotypes of the three mutation subtypes were found to be different, which can provide a basis for choosing more accurate and personalized treatment in patients with lung adenocarcinoma.
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Affiliation(s)
- Jiangdian Song
- School of Medical Informatics, China Medical University, Shenyang, China
| | - Changwei Ding
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qinlai Huang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Ting Luo
- Department of Radiology, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Xiaoman Xu
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zongjian Chen
- School of Medical Informatics, China Medical University, Shenyang, China
| | - Shu Li
- School of Medical Informatics, China Medical University, Shenyang, China
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23
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Katsuki M, Narita N, Ozaki D, Sato Y, Jia W, Nishizawa T, Kochi R, Sato K, Kawamura K, Ishida N, Watanabe O, Cai S, Shimabukuro S, Yasuda I, Kinjo K, Yokota K. Deep Learning-Based Functional Independence Measure Score Prediction After Stroke in Kaifukuki (Convalescent) Rehabilitation Ward Annexed to Acute Care Hospital. Cureus 2021; 13:e16588. [PMID: 34466308 PMCID: PMC8396410 DOI: 10.7759/cureus.16588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 01/11/2023] Open
Abstract
Introduction Prediction models of functional independent measure (FIM) score after kaifukuki (convalescent) rehabilitation ward (KRW) are needed to decide the treatment strategies and save medical resources. Statistical models were reported, but their accuracies were not satisfactory. We made such prediction models using the deep learning (DL) framework, Prediction One (Sony Network Communications Inc., Tokyo, Japan). Methods Of the 559 consecutive stroke patients, 122 patients were transferred to our KRW. We divided our 122 patients’ data randomly into halves of training and validation datasets. Prediction One made three prediction models from the training dataset using (1) variables at the acute care ward admission, (2) those at the KRW admission, and (3) those combined (1) and (2). The models’ determination coefficients (R2), correlation coefficients (rs), and residuals were calculated using the validation dataset. Results Of the 122 patients, the median age was 71, length of stay (LOS) in acute care ward 23 (17-30) days, LOS in KRW 53 days, total FIM scores at the admission of KRW 85, those at discharge 108. The mean FIM gain and FIM efficiency were 19 and 0.417. All patients were discharged home. Model (1), (2), and (3)’s R2 were 0.794, 0.970, and 0.972. Their mean residuals between the predicted and actual total FIM scores were -1.56±24.6, -4.49±17.1, and -2.69±15.7. Conclusion Our FIM gain and efficiency were better than national averages of FIM gain 17.1 and FIM efficiency 0.187. We made DL-based total FIM score prediction models, and their accuracies were superior to those of previous statistically calculated ones. The DL-based FIM score prediction models would save medical costs and perform efficient stroke and rehabilitation medicine.
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Affiliation(s)
- Masahito Katsuki
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN.,Neurosurgery, Itoigawa General Hospital, Itoigawa, JPN
| | - Norio Narita
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
| | - Dan Ozaki
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
| | | | - Wenting Jia
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
| | | | | | - Kanako Sato
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
| | | | - Naoya Ishida
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
| | - Ohmi Watanabe
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
| | - Siqi Cai
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
| | | | - Iori Yasuda
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
| | - Kengo Kinjo
- Neurosurgery, Kesennuma City Hospital, Kesennuma, JPN
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24
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Shu X, Li X, Xiang X, Wang Q, Wu Q. METTL21B is a prognostic biomarker and potential therapeutic target in low-grade gliomas. Aging (Albany NY) 2021; 13:20661-20683. [PMID: 34446611 PMCID: PMC8436898 DOI: 10.18632/aging.203454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 08/14/2021] [Indexed: 12/17/2022]
Abstract
A considerable amount of literature has demonstrated that eukaryotic translation elongation factor 1A (eEF1A) is closely related to tumors. As a newly identified lysine specific methyltransferase targeting eEF1A at Lys-165, too little attention has been paid to the function of METTL21B. To determine the potential significance and prognostic value of METTL21B in low grade glioma (LGG), we analyzed the expression, methylation level and copy number variations (CNV) of METTL21B and its effect on prognosis in patients with LGG by 4 public databases in conjunction with experimental examination of LGG patient samples. As a result, we found that high expression, hypomethylation and gain/amplification of CNV of METTL21B were associated with poor prognosis in LGG. The potential functions of METTL21B in LGG may be involved in cell adhesion, angiogenesis and cell proliferation of tumor by enrichment analysis. In addition, METTL21B may facilitate immune evasion of tumor and affect prognosis by mediating macrophage polarization from M1 to M2 and regulating expression of immune checkpoints. Nevertheless, patients with high METTL21B level are likely to have better response to immune checkpoints blockage therapy. Because of its substrate specificity, METTL21B is expected to be a promising target for the treatment of glioma.
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Affiliation(s)
- Xin Shu
- Institute of Infection, Immunology and Tumor Microenvironment, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Xinquan Li
- Institute of Infection, Immunology and Tumor Microenvironment, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Xiaochen Xiang
- Institute of Infection, Immunology and Tumor Microenvironment, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Qiang Wang
- Institute of Infection, Immunology and Tumor Microenvironment, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Qingming Wu
- Institute of Infection, Immunology and Tumor Microenvironment, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
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25
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Kinoshita M, Kanemura Y, Narita Y, Kishima H. Reverse Engineering Glioma Radiomics to Conventional Neuroimaging. Neurol Med Chir (Tokyo) 2021; 61:505-514. [PMID: 34373429 PMCID: PMC8443974 DOI: 10.2176/nmc.ra.2021-0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A novel radiological research field pursuing comprehensive quantitative image, namely “Radiomics,” gained traction along with the advancement of computational technology and artificial intelligence. This novel concept for analyzing medical images brought extensive interest to the neuro-oncology and neuroradiology research community to build a diagnostic workflow to detect clinically relevant genetic alteration of gliomas noninvasively. Although quite a few promising results were published regarding MRI-based diagnosis of isocitrate dehydrogenase (IDH) mutation in gliomas, it has become clear that an ample amount of effort is still needed to render this technology clinically applicable. At the same time, many significant insights were discovered through this research project, some of which could be “reverse engineered” to improve conventional non-radiomic MR image acquisition. In this review article, the authors aim to discuss the recent advancements and encountering issues of radiomics, how we can apply the knowledge provided by radiomics to standard clinical images, and further expected technological advances in the realm of radiomics and glioma.
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Affiliation(s)
- Manabu Kinoshita
- Department of Neurosurgery, Asahikawa Medical University.,Department of Neurosurgery, Osaka University Graduate School of Medicine.,Department of Neurosurgery, Osaka International Cancer Institute
| | - Yonehiro Kanemura
- Department of Biomedical Research and Innovation, Institute for Clinical Research, National Hospital Organization Osaka National Hospital
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital
| | - Haruhiko Kishima
- Department of Neurosurgery, Osaka University Graduate School of Medicine
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26
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Kinoshita M. [1. Current and Future Prospective of Radiomics in Glioma Imaging]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2021; 77:761-764. [PMID: 34305066 DOI: 10.6009/jjrt.2021_jsrt_77.7.761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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27
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Liu D, Chen J, Hu X, Yang K, Liu Y, Hu G, Ge H, Zhang W, Liu H. Imaging-Genomics in Glioblastoma: Combining Molecular and Imaging Signatures. Front Oncol 2021; 11:699265. [PMID: 34295824 PMCID: PMC8290166 DOI: 10.3389/fonc.2021.699265] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/23/2021] [Indexed: 12/12/2022] Open
Abstract
Based on artificial intelligence (AI), computer-assisted medical diagnosis can scientifically and efficiently deal with a large quantity of medical imaging data. AI technologies including deep learning have shown remarkable progress across medical image recognition and genome analysis. Imaging-genomics attempts to explore the associations between potential gene expression patterns and specific imaging phenotypes. These associations provide potential cellular pathophysiology information, allowing sampling of the lesion habitat with high spatial resolution. Glioblastoma (GB) poses spatial and temporal heterogeneous characteristics, challenging to current precise diagnosis and treatments for the disease. Imaging-genomics provides a powerful tool for non-invasive global assessment of GB and its response to treatment. Imaging-genomics also has the potential to advance our understanding of underlying cancer biology, gene alterations, and corresponding biological processes. This article reviews the recent progress in the utilization of the imaging-genomics analysis in GB patients, focusing on its implications and prospects in individualized diagnosis and management.
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Affiliation(s)
- Dongming Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jiu Chen
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, China.,Department of Neurosurgery, Institute of Brain Sciences, The Affilated Nanjing Brain Hosptial of Nanjing Medical University, Nanjing, China
| | - Xinhua Hu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Department of Neurosurgery, Institute of Brain Sciences, The Affilated Nanjing Brain Hosptial of Nanjing Medical University, Nanjing, China
| | - Kun Yang
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yong Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Guanjie Hu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Honglin Ge
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenbin Zhang
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Department of Neurosurgery, Institute of Brain Sciences, The Affilated Nanjing Brain Hosptial of Nanjing Medical University, Nanjing, China
| | - Hongyi Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Department of Neurosurgery, Institute of Brain Sciences, The Affilated Nanjing Brain Hosptial of Nanjing Medical University, Nanjing, China
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28
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La Greca Saint-Esteven A, Vuong D, Tschanz F, van Timmeren JE, Dal Bello R, Waller V, Pruschy M, Guckenberger M, Tanadini-Lang S. Systematic Review on the Association of Radiomics with Tumor Biological Endpoints. Cancers (Basel) 2021; 13:cancers13123015. [PMID: 34208595 PMCID: PMC8234501 DOI: 10.3390/cancers13123015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 12/23/2022] Open
Abstract
Radiomics supposes an alternative non-invasive tumor characterization tool, which has experienced increased interest with the advent of more powerful computers and more sophisticated machine learning algorithms. Nonetheless, the incorporation of radiomics in cancer clinical-decision support systems still necessitates a thorough analysis of its relationship with tumor biology. Herein, we present a systematic review focusing on the clinical evidence of radiomics as a surrogate method for tumor molecular profile characterization. An extensive literature review was conducted in PubMed, including papers on radiomics and a selected set of clinically relevant and commonly used tumor molecular markers. We summarized our findings based on different cancer entities, additionally evaluating the effect of different modalities for the prediction of biomarkers at each tumor site. Results suggest the existence of an association between the studied biomarkers and radiomics from different modalities and different tumor sites, even though a larger number of multi-center studies are required to further validate the reported outcomes.
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Affiliation(s)
- Agustina La Greca Saint-Esteven
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, 8091 Zurich, Switzerland; (D.V.); (J.E.v.T.); (R.D.B.); (M.G.); (S.T.-L.)
- Correspondence:
| | - Diem Vuong
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, 8091 Zurich, Switzerland; (D.V.); (J.E.v.T.); (R.D.B.); (M.G.); (S.T.-L.)
| | - Fabienne Tschanz
- Laboratory of Applied Radiobiology, Department of Radiation Oncology, University of Zurich, 8091 Zurich, Switzerland; (F.T.); (V.W.); (M.P.)
| | - Janita E. van Timmeren
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, 8091 Zurich, Switzerland; (D.V.); (J.E.v.T.); (R.D.B.); (M.G.); (S.T.-L.)
| | - Riccardo Dal Bello
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, 8091 Zurich, Switzerland; (D.V.); (J.E.v.T.); (R.D.B.); (M.G.); (S.T.-L.)
| | - Verena Waller
- Laboratory of Applied Radiobiology, Department of Radiation Oncology, University of Zurich, 8091 Zurich, Switzerland; (F.T.); (V.W.); (M.P.)
| | - Martin Pruschy
- Laboratory of Applied Radiobiology, Department of Radiation Oncology, University of Zurich, 8091 Zurich, Switzerland; (F.T.); (V.W.); (M.P.)
| | - Matthias Guckenberger
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, 8091 Zurich, Switzerland; (D.V.); (J.E.v.T.); (R.D.B.); (M.G.); (S.T.-L.)
| | - Stephanie Tanadini-Lang
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, 8091 Zurich, Switzerland; (D.V.); (J.E.v.T.); (R.D.B.); (M.G.); (S.T.-L.)
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Katsuki M, Kakizawa Y, Nishikawa A, Yamamoto Y, Uchiyama T. Postsurgical functional outcome prediction model using deep learning framework (Prediction One, Sony Network Communications Inc.) for hypertensive intracerebral hemorrhage. Surg Neurol Int 2021; 12:203. [PMID: 34084630 PMCID: PMC8168705 DOI: 10.25259/sni_222_2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 04/14/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Reliable prediction models of intracerebral hemorrhage (ICH) outcomes are needed for decision-making of the treatment. Statistically making such prediction models needs a large number of samples and time-consuming statistical analysis. Deep learning (DL), one of the artificial intelligence, is attractive, but there were no reports on DL-based functional outcome prediction models for ICH outcomes after surgery. We herein made a functional outcome prediction model using DLframework, Prediction One (Sony Network Communications Inc., Tokyo, Japan), and compared it to original ICH score, ICH Grading Scale, and FUNC score. METHODS We used 140 consecutive hypertensive ICH patients' data in our hospital between 2012 and 2019. All patients were surgically treated. Modified Rankin Scale 0-3 at 6 months was defined as a favorable outcome. We randomly divided them into 100 patients training dataset and 40 patients validation dataset. Prediction One made the prediction model using the training dataset with 5-fold cross-validation. We calculated area under the curves (AUCs) regarding the outcome using the DL-based model, ICH score, ICH Grading Scale, and FUNC score. The AUCs were compared. RESULTS The model made by Prediction One using 64 variables had AUC of 0.997 in the training dataset and that of 0.884 in the validation dataset. These AUCs were superior to those derived from ICH score, ICH Grading Scale, and FUNC score. CONCLUSION We easily and quickly made prediction models using Prediction One, even with a small single-center dataset. The accuracy of the DL-based model was superior to those of previous statistically calculated models.
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Affiliation(s)
- Masahito Katsuki
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa, Nagano, Japan
| | - Yukinari Kakizawa
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa, Nagano, Japan
| | - Akihiro Nishikawa
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa, Nagano, Japan
| | - Yasunaga Yamamoto
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa, Nagano, Japan
| | - Toshiya Uchiyama
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa, Nagano, Japan
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30
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Viswanath P, Batsios G, Ayyappan V, Taglang C, Gillespie AM, Larson PEZ, Luchman HA, Costello JF, Pieper RO, Ronen SM. Metabolic imaging detects elevated glucose flux through the pentose phosphate pathway associated with TERT expression in low-grade gliomas. Neuro Oncol 2021; 23:1509-1522. [PMID: 33864084 DOI: 10.1093/neuonc/noab093] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Telomerase reverse transcriptase (TERT) is essential for tumor proliferation, including in low-grade oligodendrogliomas (LGOGs). Since TERT is silenced in normal cells, it is also a therapeutic target. Therefore, non-invasive methods of imaging TERT are needed. Here, we examined the link between TERT expression and metabolism in LGOGs, with the goal of leveraging this information for non-invasive magnetic resonance spectroscopy (MRS)-based metabolic imaging of LGOGs. METHODS Immortalized normal human astrocytes with doxycycline-inducible TERT silencing, patient-derived LGOG cells, orthotopic tumors and LGOG patient biopsies were studied to determine the mechanistic link between TERT expression and glucose metabolism. The ability of hyperpolarized [U- 13C, U- 2H]-glucose to non-invasively assess TERT expression was tested in live cells and orthotopic tumors. RESULTS TERT expression was associated with elevated glucose flux through the pentose phosphate pathway (PPP), elevated NADPH, which is a major product of the PPP, and elevated GSH, which is maintained in a reduced state by NADPH. Importantly, hyperpolarized [U- 13C, U- 2H]-glucose metabolism via the PPP non-invasively reported on TERT expression and response to TERT inhibition in patient-derived LGOG cells and orthotopic tumors. Mechanistically, TERT acted via the sirtuin SIRT2 to upregulate the glucose transporter GLUT1 and the rate-limiting PPP enzyme glucose-6-phosphate dehydrogenase. CONCLUSIONS We have, for the first time, leveraged a mechanistic understanding of TERT-associated metabolic reprogramming for non-invasive imaging of LGOGs using hyperpolarized [U- 13C, U- 2H]-glucose. Our findings provide a novel way of imaging a hallmark of tumor immortality and have the potential to improve diagnosis and treatment response assessment for LGOG patients.
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Affiliation(s)
- Pavithra Viswanath
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Georgios Batsios
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Vinay Ayyappan
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Celiné Taglang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Anne Marie Gillespie
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - H Artee Luchman
- Department of Cell Biology and Anatomy and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Joseph F Costello
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Russell O Pieper
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Sabrina M Ronen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
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31
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Jian A, Jang K, Manuguerra M, Liu S, Magnussen J, Di Ieva A. Machine Learning for the Prediction of Molecular Markers in Glioma on Magnetic Resonance Imaging: A Systematic Review and Meta-Analysis. Neurosurgery 2021; 89:31-44. [PMID: 33826716 DOI: 10.1093/neuros/nyab103] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/24/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Molecular characterization of glioma has implications for prognosis, treatment planning, and prediction of treatment response. Current histopathology is limited by intratumoral heterogeneity and variability in detection methods. Advances in computational techniques have led to interest in mining quantitative imaging features to noninvasively detect genetic mutations. OBJECTIVE To evaluate the diagnostic accuracy of machine learning (ML) models in molecular subtyping gliomas on preoperative magnetic resonance imaging (MRI). METHODS A systematic search was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines to identify studies up to April 1, 2020. Methodological quality of studies was assessed using the Quality Assessment for Diagnostic Accuracy Studies (QUADAS)-2. Diagnostic performance estimates were obtained using a bivariate model and heterogeneity was explored using metaregression. RESULTS Forty-four original articles were included. The pooled sensitivity and specificity for predicting isocitrate dehydrogenase (IDH) mutation in training datasets were 0.88 (95% CI 0.83-0.91) and 0.86 (95% CI 0.79-0.91), respectively, and 0.83 to 0.85 in validation sets. Use of data augmentation and MRI sequence type were weakly associated with heterogeneity. Both O6-methylguanine-DNA methyltransferase (MGMT) gene promoter methylation and 1p/19q codeletion could be predicted with a pooled sensitivity and specificity between 0.76 and 0.83 in training datasets. CONCLUSION ML application to preoperative MRI demonstrated promising results for predicting IDH mutation, MGMT methylation, and 1p/19q codeletion in glioma. Optimized ML models could lead to a noninvasive, objective tool that captures molecular information important for clinical decision making. Future studies should use multicenter data, external validation and investigate clinical feasibility of ML models.
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Affiliation(s)
- Anne Jian
- Computational NeuroSurgery (CNS) Lab, Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.,Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - Kevin Jang
- Computational NeuroSurgery (CNS) Lab, Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.,Discipline of Surgery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Maurizio Manuguerra
- Department of Mathematics and Statistics, Faculty of Science and Engineering, Macquarie University, Sydney, Australia
| | - Sidong Liu
- Computational NeuroSurgery (CNS) Lab, Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.,Centre for Health Informatics, Macquarie University, Sydney, Australia
| | - John Magnussen
- Computational NeuroSurgery (CNS) Lab, Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.,Macquarie Medical Imaging, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Antonio Di Ieva
- Computational NeuroSurgery (CNS) Lab, Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.,Macquarie Neurosurgery, Macquarie University, Sydney, Australia
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32
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Le NQK, Hung TNK, Do DT, Lam LHT, Dang LH, Huynh TT. Radiomics-based machine learning model for efficiently classifying transcriptome subtypes in glioblastoma patients from MRI. Comput Biol Med 2021; 132:104320. [PMID: 33735760 DOI: 10.1016/j.compbiomed.2021.104320] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/05/2021] [Accepted: 03/05/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND In the field of glioma, transcriptome subtypes have been considered as an important diagnostic and prognostic biomarker that may help improve the treatment efficacy. However, existing identification methods of transcriptome subtypes are limited due to the relatively long detection period, the unattainability of tumor specimens via biopsy or surgery, and the fleeting nature of intralesional heterogeneity. In search of a superior model over previous ones, this study evaluated the efficiency of eXtreme Gradient Boosting (XGBoost)-based radiomics model to classify transcriptome subtypes in glioblastoma patients. METHODS This retrospective study retrieved patients from TCGA-GBM and IvyGAP cohorts with pathologically diagnosed glioblastoma, and separated them into different transcriptome subtypes groups. GBM patients were then segmented into three different regions of MRI: enhancement of the tumor core (ET), non-enhancing portion of the tumor core (NET), and peritumoral edema (ED). We subsequently used handcrafted radiomics features (n = 704) from multimodality MRI and two-level feature selection techniques (Spearman correlation and F-score tests) in order to find the features that could be relevant. RESULTS After the feature selection approach, we identified 13 radiomics features that were the most meaningful ones that can be used to reach the optimal results. With these features, our XGBoost model reached the predictive accuracies of 70.9%, 73.3%, 88.4%, and 88.4% for classical, mesenchymal, neural, and proneural subtypes, respectively. Our model performance has been improved in comparison with the other models as well as previous works on the same dataset. CONCLUSION The use of XGBoost and two-level feature selection analysis (Spearman correlation and F-score) could be expected as a potential combination for classifying transcriptome subtypes with high performance and might raise public attention for further research on radiomics-based GBM models.
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Affiliation(s)
- Nguyen Quoc Khanh Le
- Professional Master Program in Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, Taipei, 106, Taiwan; Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei, 106, Taiwan; Translational Imaging Research Center, Taipei Medical University Hospital, Taipei, 110, Taiwan.
| | - Truong Nguyen Khanh Hung
- International Master/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, 110, Taiwan; Orthopedic and Trauma Department, Cho Ray Hospital, Ho Chi Minh City, 70000, Viet Nam
| | - Duyen Thi Do
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, 106, Taiwan
| | - Luu Ho Thanh Lam
- International Master/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, 110, Taiwan; Children's Hospital 2, Ho Chi Minh City, 70000, Viet Nam
| | - Luong Huu Dang
- Department of Otolaryngology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, 70000, Viet Nam
| | - Tuan-Tu Huynh
- Department of Electrical Engineering, Yuan Ze University, No. 135, Yuandong Road, Zhongli, 320, Taoyuan, Taiwan; Department of Electrical Electronic and Mechanical Engineering, Lac Hong University, No. 10, Huynh Van Nghe Road, Bien Hoa, Dong Nai, 76120, Viet Nam
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Fang S, Fan Z, Sun Z, Li Y, Liu X, Liang Y, Liu Y, Zhou C, Zhu Q, Zhang H, Li T, Li S, Jiang T, Wang Y, Wang L. Radiomics Features Predict Telomerase Reverse Transcriptase Promoter Mutations in World Health Organization Grade II Gliomas via a Machine-Learning Approach. Front Oncol 2021; 10:606741. [PMID: 33643908 PMCID: PMC7905226 DOI: 10.3389/fonc.2020.606741] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/24/2020] [Indexed: 12/16/2022] Open
Abstract
The detection of mutations in telomerase reverse transcriptase promoter (pTERT) is important since preoperative diagnosis of pTERT status helps with evaluating prognosis and determining the surgical strategy. Here, we aimed to establish a radiomics-based machine-learning algorithm and evaluated its performance with regard to the prediction of mutations in pTERT in patients with World Health Organization (WHO) grade II gliomas. In total, 164 patients with WHO grade II gliomas were enrolled in this retrospective study. We extracted a total of 1,293 radiomics features from multi-parametric magnetic resonance imaging scans. Elastic net (used for feature selection) and support vector machine with linear kernel were applied in nested 10-fold cross-validation loops. The predictive model was evaluated by receiver operating characteristic and precision-recall analyses. We performed an unpaired t-test to compare the posterior predictive probabilities among patients with differing pTERT statuses. We selected 12 valuable radiomics features using nested 10-fold cross-validation loops. The area under the curve (AUC) was 0.8446 (95% confidence interval [CI], 0.7735–0.9065) with an optimal summed value of sensitivity of 0.9355 (95% CI, 0.8802–0.9788) and specificity of 0.6197 (95% CI, 0.5071–0.7371). The overall accuracy was 0.7988 (95% CI, 0.7378–0.8598). The F1-score was 0.8406 (95% CI, 0.7684–0.902) with an optimal precision of 0.7632 (95% CI, 0.6818–0.8364) and recall of 0.9355 (95% CI, 0.8802–0.9788). Posterior probabilities of pTERT mutations were significantly different between patients with wild-type and mutant TERT promoters. Our findings suggest that a radiomics analysis with a machine-learning algorithm can be useful for predicting pTERT status in patients with WHO grade II glioma and may aid in glioma management.
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Affiliation(s)
- Shengyu Fang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Ziwen Fan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhiyan Sun
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Yiming Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xing Liu
- Department of Pathology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yuchao Liang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yukun Liu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chunyao Zhou
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qiang Zhu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hong Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tianshi Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shaowu Li
- Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tao Jiang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yinyan Wang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Lei Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Katsuki M, Narita N, Ishida N, Watanabe O, Cai S, Ozaki D, Sato Y, Kato Y, Jia W, Nishizawa T, Kochi R, Sato K, Tominaga T. Preliminary development of a prediction model for daily stroke occurrences based on meteorological and calendar information using deep learning framework (Prediction One; Sony Network Communications Inc., Japan). Surg Neurol Int 2021; 12:31. [PMID: 33598347 PMCID: PMC7881509 DOI: 10.25259/sni_774_2020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/07/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Chronologically meteorological and calendar factors were risks of stroke occurrence. However, the prediction of stroke occurrences is difficult depending on only meteorological and calendar factors. We tried to make prediction models for stroke occurrences using deep learning (DL) software, Prediction One (Sony Network Communications Inc., Tokyo, Japan), with those variables. METHODS We retrospectively investigated the daily stroke occurrences between 2017 and 2019. We used Prediction One software to make the prediction models for daily stroke occurrences (present or absent) using 221 chronologically meteorological and calendar factors. We made a prediction models from the 3-year dataset and evaluated their accuracies using the internal cross-validation. Areas under the curves (AUCs) of receiver operating characteristic curves were used as accuracies. RESULTS The 371 cerebral infarction (CI), 184 intracerebral hemorrhage (ICH), and 53 subarachnoid hemorrhage patients were included in the study. The AUCs of the several DL-based prediction models for all stroke occurrences were 0.532-0.757. Those for CI were 0.600-0.782. Those for ICH were 0.714-0.988. CONCLUSION Our preliminary results suggested a probability of the DL-based prediction models for stroke occurrence only by meteorological and calendar factors. In the future, by synchronizing a variety of medical information among the electronic medical records and personal smartphones as well as integrating the physical activities or meteorological conditions in real time, the prediction of stroke occurrence could be performed with high accuracy, to save medical resources, to have patients care for themselves, and to perform efficient medicine.
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Affiliation(s)
- Masahito Katsuki
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Norio Narita
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Naoya Ishida
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Ohmi Watanabe
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Siqi Cai
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Dan Ozaki
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Yoshimichi Sato
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Yuya Kato
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Wenting Jia
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Taketo Nishizawa
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Ryuzaburo Kochi
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Kanako Sato
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University, Sendai, Miyagi, Japan
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Kinoshita M, Arita H, Takahashi M, Uda T, Fukai J, Ishibashi K, Kijima N, Hirayama R, Sakai M, Arisawa A, Takahashi H, Nakanishi K, Kagawa N, Ichimura K, Kanemura Y, Narita Y, Kishima H. Impact of Inversion Time for FLAIR Acquisition on the T2-FLAIR Mismatch Detectability for IDH-Mutant, Non-CODEL Astrocytomas. Front Oncol 2021; 10:596448. [PMID: 33520709 PMCID: PMC7841010 DOI: 10.3389/fonc.2020.596448] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/30/2020] [Indexed: 11/29/2022] Open
Abstract
The current research tested the hypothesis that inversion time (TI) shorter than 2,400 ms under 3T for FLAIR can improve the diagnostic accuracy of the T2-FLAIR mismatch sign for identifying IDHmt, non-CODEL astrocytomas. We prepared three different cohorts; 94 MRI from 76 IDHmt, non-CODEL Lower-grade gliomas (LrGGs), 33 MRI from 31 LrGG under the restriction of FLAIR being acquired with TI < 2,400 ms for 3T or 2,016 ms for 1.5T, and 112 MRI from 112 patients from the TCIA/TCGA dataset for LrGG. The presence or absence of the “T2-FLAIR mismatch sign” was evaluated, and we compared diagnostic accuracies according to TI used for FLAIR acquisition. The T2-FLAIR mismatch sign was more frequently positive when TI was shorter than 2,400 ms under 3T for FLAIR acquisition (p = 0.0009, Fisher’s exact test). The T2-FLAIR mismatch sign was positive only for IDHmt, non-CODEL astrocytomas even if we confined the cohort with FLAIR acquired with shorter TI (p = 0.0001, Fisher’s exact test). TCIA/TCGA dataset validated that the sensitivity, specificity, PPV, and NPV of the T2-FLAIR mismatch sign to identify IDHmt, non-CODEL astrocytomas improved from 31, 90, 79, and 51% to 67, 94, 92, and 74%, respectively and the area under the curve of ROC improved from 0.63 to 0.87 when FLAIR was acquired with shorter TI. We revealed that TI for FLAIR impacts the T2-FLAIR mismatch sign’s diagnostic accuracy and that FLAIR scanned with TI < 2,400 ms in 3T is necessary for LrGG imaging.
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Affiliation(s)
- Manabu Kinoshita
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hideyuki Arita
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.,Department of Neurosurgery, Takatsuki General Hospital, Takatsuki, Japan
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Takehiro Uda
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Junya Fukai
- Department of Neurological Surgery, Wakayama Medical University, Wakayama, Japan
| | - Kenichi Ishibashi
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Noriyuki Kijima
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Ryuichi Hirayama
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Mio Sakai
- Department of Diagnostic Radiology, Osaka International Cancer Institute, Osaka, Japan
| | - Atsuko Arisawa
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hiroto Takahashi
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Katsuyuki Nakanishi
- Department of Diagnostic Radiology, Osaka International Cancer Institute, Osaka, Japan
| | - Naoki Kagawa
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kouichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan
| | - Yonehiro Kanemura
- Department of Biomedical Research and Innovation, Institute for Clinical Research, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Haruhiko Kishima
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
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Beig N, Bera K, Tiwari P. Introduction to radiomics and radiogenomics in neuro-oncology: implications and challenges. Neurooncol Adv 2020; 2:iv3-iv14. [PMID: 33521636 PMCID: PMC7829475 DOI: 10.1093/noajnl/vdaa148] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Neuro-oncology largely consists of malignancies of the brain and central nervous system including both primary as well as metastatic tumors. Currently, a significant clinical challenge in neuro-oncology is to tailor therapies for patients based on a priori knowledge of their survival outcome or treatment response to conventional or experimental therapies. Radiomics or the quantitative extraction of subvisual data from conventional radiographic imaging has recently emerged as a powerful data-driven approach to offer insights into clinically relevant questions related to diagnosis, prediction, prognosis, as well as assessing treatment response. Furthermore, radiogenomic approaches provide a mechanism to establish statistical correlations of radiomic features with point mutations and next-generation sequencing data to further leverage the potential of routine MRI scans to serve as "virtual biopsy" maps. In this review, we provide an introduction to radiomic and radiogenomic approaches in neuro-oncology, including a brief description of the workflow involving preprocessing, tumor segmentation, and extraction of "hand-crafted" features from the segmented region of interest, as well as identifying radiogenomic associations that could ultimately lead to the development of reliable prognostic and predictive models in neuro-oncology applications. Lastly, we discuss the promise of radiomics and radiogenomic approaches in personalizing treatment decisions in neuro-oncology, as well as the challenges with clinical adoption, which will rely heavily on their demonstrated resilience to nonstandardization in imaging protocols across sites and scanners, as well as in their ability to demonstrate reproducibility across large multi-institutional cohorts.
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Affiliation(s)
- Niha Beig
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Kaustav Bera
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Pallavi Tiwari
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
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37
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Bhandari AP, Liong R, Koppen J, Murthy SV, Lasocki A. Noninvasive Determination of IDH and 1p19q Status of Lower-grade Gliomas Using MRI Radiomics: A Systematic Review. AJNR Am J Neuroradiol 2020; 42:94-101. [PMID: 33243896 DOI: 10.3174/ajnr.a6875] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 08/17/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Determination of isocitrate dehydrogenase (IDH) status and, if IDH-mutant, assessing 1p19q codeletion are an important component of diagnosis of World Health Organization grades II/III or lower-grade gliomas. This has led to research into noninvasively correlating imaging features ("radiomics") with genetic status. PURPOSE Our aim was to perform a diagnostic test accuracy systematic review for classifying IDH and 1p19q status using MR imaging radiomics, to provide future directions for integration into clinical radiology. DATA SOURCES Ovid (MEDLINE), Scopus, and the Web of Science were searched in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Diagnostic Test Accuracy guidelines. STUDY SELECTION Fourteen journal articles were selected that included 1655 lower-grade gliomas classified by their IDH and/or 1p19q status from MR imaging radiomic features. DATA ANALYSIS For each article, the classification of IDH and/or 1p19q status using MR imaging radiomics was evaluated using the area under curve or descriptive statistics. Quality assessment was performed with the Quality Assessment of Diagnostic Accuracy Studies 2 tool and the radiomics quality score. DATA SYNTHESIS The best classifier of IDH status was with conventional radiomics in combination with convolutional neural network-derived features (area under the curve = 0.95, 94.4% sensitivity, 86.7% specificity). Optimal classification of 1p19q status occurred with texture-based radiomics (area under the curve = 0.96, 90% sensitivity, 89% specificity). LIMITATIONS A meta-analysis showed high heterogeneity due to the uniqueness of radiomic pipelines. CONCLUSIONS Radiogenomics is a potential alternative to standard invasive biopsy techniques for determination of IDH and 1p19q status in lower-grade gliomas but requires translational research for clinical uptake.
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Affiliation(s)
- A P Bhandari
- From the Department of Anatomy (A.P.B.) .,Townsville University Hospital (A.P.B., J.K.), Douglas, Queensland, Australia
| | - R Liong
- Department of Medical Imaging Research Office (R.L.), Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - J Koppen
- Townsville University Hospital (A.P.B., J.K.), Douglas, Queensland, Australia
| | - S V Murthy
- College of Medicine and Dentistry (S.V.M.), James Cook University, Townsville, Queensland, Australia
| | - A Lasocki
- Department of Cancer Imaging (A.L.), Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology (A.L.), The University of Melbourne, Melbourne, Victoria, Australia
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Zadeh Shirazi A, Fornaciari E, McDonnell MD, Yaghoobi M, Cevallos Y, Tello-Oquendo L, Inca D, Gomez GA. The Application of Deep Convolutional Neural Networks to Brain Cancer Images: A Survey. J Pers Med 2020; 10:E224. [PMID: 33198332 PMCID: PMC7711876 DOI: 10.3390/jpm10040224] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 12/15/2022] Open
Abstract
In recent years, improved deep learning techniques have been applied to biomedical image processing for the classification and segmentation of different tumors based on magnetic resonance imaging (MRI) and histopathological imaging (H&E) clinical information. Deep Convolutional Neural Networks (DCNNs) architectures include tens to hundreds of processing layers that can extract multiple levels of features in image-based data, which would be otherwise very difficult and time-consuming to be recognized and extracted by experts for classification of tumors into different tumor types, as well as segmentation of tumor images. This article summarizes the latest studies of deep learning techniques applied to three different kinds of brain cancer medical images (histology, magnetic resonance, and computed tomography) and highlights current challenges in the field for the broader applicability of DCNN in personalized brain cancer care by focusing on two main applications of DCNNs: classification and segmentation of brain cancer tumors images.
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Affiliation(s)
- Amin Zadeh Shirazi
- Centre for Cancer Biology, SA Pathology and the University of South of Australia, Adelaide, SA 5000, Australia;
- Computational Learning Systems Laboratory, UniSA STEM, University of South Australia, Mawson Lakes, SA 5095, Australia;
| | - Eric Fornaciari
- Department of Mathematics of Computation, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA;
| | - Mark D. McDonnell
- Computational Learning Systems Laboratory, UniSA STEM, University of South Australia, Mawson Lakes, SA 5095, Australia;
| | - Mahdi Yaghoobi
- Electrical and Computer Engineering Department, Islamic Azad University, Mashhad Branch, Mashad 917794-8564, Iran;
| | - Yesenia Cevallos
- College of Engineering, Universidad Nacional de Chimborazo, Riobamba 060150, Ecuador; (Y.C.); (L.T.-O.); (D.I.)
| | - Luis Tello-Oquendo
- College of Engineering, Universidad Nacional de Chimborazo, Riobamba 060150, Ecuador; (Y.C.); (L.T.-O.); (D.I.)
| | - Deysi Inca
- College of Engineering, Universidad Nacional de Chimborazo, Riobamba 060150, Ecuador; (Y.C.); (L.T.-O.); (D.I.)
| | - Guillermo A. Gomez
- Centre for Cancer Biology, SA Pathology and the University of South of Australia, Adelaide, SA 5000, Australia;
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Katsuki M, Kakizawa Y, Nishikawa A, Yamamoto Y, Uchiyama T. Easily created prediction model using deep learning software (Prediction One, Sony Network Communications Inc.) for subarachnoid hemorrhage outcomes from small dataset at admission. Surg Neurol Int 2020; 11:374. [PMID: 33408908 PMCID: PMC7771510 DOI: 10.25259/sni_636_2020] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 10/15/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Reliable prediction models of subarachnoid hemorrhage (SAH) outcomes are needed for decision-making of the treatment. SAFIRE score using only four variables is a good prediction scoring system. However, making such prediction models needs a large number of samples and time-consuming statistical analysis. Deep learning (DL), one of the artificial intelligence, is attractive, but there were no reports on prediction models for SAH outcomes using DL. We herein made a prediction model using DL software, Prediction One (Sony Network Communications Inc., Tokyo, Japan) and compared it to SAFIRE score. METHODS We used 153 consecutive aneurysmal SAH patients data in our hospital between 2012 and 2019. Modified Rankin Scale (mRS) 0-3 at 6 months was defined as a favorable outcome. We randomly divided them into 102 patients training dataset and 51 patients external validation dataset. Prediction one made the prediction model using the training dataset with internal cross-validation. We used both the created model and SAFIRE score to predict the outcomes using the external validation set. The areas under the curve (AUCs) were compared. RESULTS The model made by Prediction One using 28 variables had AUC of 0.848, and its AUC for the validation dataset was 0.953 (95%CI 0.900-1.000). AUCs calculated using SAFIRE score were 0.875 for the training dataset and 0.960 for the validation dataset, respectively. CONCLUSION We easily and quickly made prediction models using Prediction One, even with a small single-center dataset. The accuracy of the model was not so inferior to those of previous statistically calculated prediction models.
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Dysregulated Expression and Methylation Analysis Identified TLX1NB as a Novel Recurrence Marker in Low-Grade Gliomas. Int J Genomics 2020; 2020:5069204. [PMID: 33102572 PMCID: PMC7576335 DOI: 10.1155/2020/5069204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 09/22/2020] [Indexed: 11/17/2022] Open
Abstract
Low-grade gliomas (LGGs) are the most common CNS tumors, and the main therapy for LGGs is complete surgical resection, due to its curative effect. However, LGG recurrence occurs frequently. Biomarkers play a crucial role in evaluating the recurrence and prognosis of LGGs. Numerous studies have focused on LGG prognosis. However, the multiomics research investigating the roles played by gene methylation and expression in LGG recurrence remains limited. In this study, we integrated the TCGA and GEO datasets, analyzing RNA and methylation data for recurrence (R) and nonrecurrence (NR) groups. We found a low expression of TLX1NB and high methylation in recurrence patients. Low expression of TLX1NB is associated with poor survival (OS: p = 0.04). The expression of TLX1NB is likely to play a role in the prognosis of LGG. Therefore, TLX1NB may represent an alternative early biomarker for the recurrence of low-grade gliomas.
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Toussaint M, Deuther-Conrad W, Kranz M, Fischer S, Ludwig FA, Juratli TA, Patt M, Wünsch B, Schackert G, Sabri O, Brust P. Sigma-1 Receptor Positron Emission Tomography: A New Molecular Imaging Approach Using ( S)-(-)-[ 18F]Fluspidine in Glioblastoma. Molecules 2020; 25:E2170. [PMID: 32384802 PMCID: PMC7248975 DOI: 10.3390/molecules25092170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/30/2020] [Accepted: 05/02/2020] [Indexed: 11/16/2022] Open
Abstract
Glioblastoma multiforme (GBM) is the most devastating primary brain tumour characterised by infiltrative growth and resistance to therapies. According to recent research, the sigma-1 receptor (sig1R), an endoplasmic reticulum chaperone protein, is involved in signaling pathways assumed to control the proliferation of cancer cells and thus could serve as candidate for molecular characterisation of GBM. To test this hypothesis, we used the clinically applied sig1R-ligand (S)-(-)-[18F]fluspidine in imaging studies in an orthotopic mouse model of GBM (U87-MG) as well as in human GBM tissue. A tumour-specific overexpression of sig1R in the U87-MG model was revealed in vitro by autoradiography. The binding parameters demonstrated target-selective binding according to identical KD values in the tumour area and the contralateral side, but a higher density of sig1R in the tumour. Different kinetic profiles were observed in both areas, with a slower washout in the tumour tissue compared to the contralateral side. The translational relevance of sig1R imaging in oncology is reflected by the autoradiographic detection of tumour-specific expression of sig1R in samples obtained from patients with glioblastoma. Thus, the herein presented data support further research on sig1R in neuro-oncology.
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Affiliation(s)
- Magali Toussaint
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Department of Neuroradiopharmaceuticals, Research site Leipzig, 04318 Leipzig, Germany; (W.D.-C.); (M.K.); (S.F.); (F.-A.L.); (P.B.)
| | - Winnie Deuther-Conrad
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Department of Neuroradiopharmaceuticals, Research site Leipzig, 04318 Leipzig, Germany; (W.D.-C.); (M.K.); (S.F.); (F.-A.L.); (P.B.)
| | - Mathias Kranz
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Department of Neuroradiopharmaceuticals, Research site Leipzig, 04318 Leipzig, Germany; (W.D.-C.); (M.K.); (S.F.); (F.-A.L.); (P.B.)
- PET Imaging Center, University Hospital of North Norway (UNN), 9009 Tromsø, Norway
- Nuclear Medicine and Radiation Biology Research Group, The Arctic University of Norway, 9009 Tromsø, Norway
| | - Steffen Fischer
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Department of Neuroradiopharmaceuticals, Research site Leipzig, 04318 Leipzig, Germany; (W.D.-C.); (M.K.); (S.F.); (F.-A.L.); (P.B.)
| | - Friedrich-Alexander Ludwig
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Department of Neuroradiopharmaceuticals, Research site Leipzig, 04318 Leipzig, Germany; (W.D.-C.); (M.K.); (S.F.); (F.-A.L.); (P.B.)
| | - Tareq A. Juratli
- Department of Neurosurgery, Technische Universität Dresden (TUD), University Hospital Carl Gustav Carus, 01307 Dresden, Germany; (T.A.J.); (G.S.)
| | - Marianne Patt
- Department of Nuclear Medicine, University Hospital Leipzig, 04318 Leipzig, Germany; (M.P.); (O.S.)
| | - Bernhard Wünsch
- Institute of Pharmaceutical and Medicinal Chemistry, University of Münster, 48149 Münster, Germany;
| | - Gabriele Schackert
- Department of Neurosurgery, Technische Universität Dresden (TUD), University Hospital Carl Gustav Carus, 01307 Dresden, Germany; (T.A.J.); (G.S.)
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital Leipzig, 04318 Leipzig, Germany; (M.P.); (O.S.)
| | - Peter Brust
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Department of Neuroradiopharmaceuticals, Research site Leipzig, 04318 Leipzig, Germany; (W.D.-C.); (M.K.); (S.F.); (F.-A.L.); (P.B.)
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