Abstract

PurposeThis study aimed to investigate the effectiveness of using delta-radiomics to predict overall survival (OS) for patients with recurrent malignant gliomas treated by concurrent stereotactic radiosurgery and bevacizumab, and to investigate the effectiveness of machine learning methods for delta-radiomics feature selection and building classification models.MethodsThe pre-treatment, one-week post-treatment, and two-month post-treatment T1 and T2 fluid-attenuated inversion recovery (FLAIR) MRI were acquired. 61 radiomic features (intensity histogram-based, morphological, and texture features) were extracted from the gross tumor volume in each image. Delta-radiomics were calculated between the pre-treatment and post-treatment features. Univariate Cox regression and 3 multivariate machine learning methods (L1-regularized logistic regression [L1-LR], random forest [RF] or neural networks [NN]) were used to select a reduced number of features, and 7 machine learning methods (L1-LR, L2-LR, RF, NN, kernel support vector machine [KSVM], linear support vector machine [LSVM], or naïve bayes [NB]) was used to build classification models for predicting OS. The performances of the total 21 model combinations built based on single-time-point radiomics (pre-treatment, one-week post-treatment, and two-month post-treatment) and delta-radiomics were evaluated by the area under the receiver operating characteristic curve (AUC).ResultsFor a small cohort of 12 patients, delta-radiomics resulted in significantly higher AUC than pre-treatment radiomics (p-value<0.01). One-week/two-month delta-features resulted in significantly higher AUC (p-value<0.01) than the one-week/two-month post-treatment features, respectively. 18/21 model combinations were with higher AUC from one-week delta-features than two-month delta-features. With one-week delta-features, RF feature selector + KSVM classifier and RF feature selector + NN classifier showed the highest AUC of 0.889.ConclusionsThe results indicated that delta-features could potentially provide better treatment assessment than single-time-point features. The treatment assessment is substantially affected by the time point for computing the delta-features and the combination of machine learning methods for feature selection and classification.

Highlights

  • Radiomics is being actively investigated by computing high-dimensional quantitative features from medical images (CT, MRI, PET, etc.) to provide predictive, prognostic, or diagnostic decision support[1, 2]

  • Based on paired-sample t-test, models built with ΔF1 or ΔF2 showed significantly higher area under the curve (AUC) than those built with Fpre (p-value < 0.01)

  • When random forest (RF) and neural networks (NN) were used for feature selection, ΔF1 resulted in higher predictive performance than ΔF2, independent of the type of machine learning algorithm used for classification (p-value < 0.01)

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Summary

Introduction

Radiomics is being actively investigated by computing high-dimensional quantitative features from medical images (CT, MRI, PET, etc.) to provide predictive, prognostic, or diagnostic decision support[1, 2]. Features in radiomic studies are typically defined in one of two ways: (1) single-time-point radiomics, where features are extracted from a particular image (e.g., pre-treatment)[6, 16, 17], and (2) delta-radiomics, where features are extracted from a time series of images (e.g., preand post-treatment)[18]. The latter technique reflects the temporal change of radiomic features. Delta-radiomics have been shown to be effective in assessing the response of colorectal liver metastases to chemotherapy[19], differentiating radiation pneumonitis following radiotherapy (RT)[20], predicting overall survival (OS) of patients with non-small cell lung cancer (NSCLC) treated with RT[21], and predicting OS, progression-free survival, and early/late progressors for recurrent glioblastoma multiforme to bevacizumab treatment[22]

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