Abstract

In neuro-oncology, magnetic resonance imaging (MRI) is a critically important, non-invasive radiologic assessment technique for brain tumor diagnosis, especially glioma. Deep learning improves MRI image characterization and interpretation through the utilization of raw imaging data and provides unprecedented enhancement of images and representation for detection and classification through deep neural networks. This systematic review and quality appraisal method aim to summarize deep learning approaches used in neuro-oncology imaging to aid healthcare professionals. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a total of 20 low-risk studies on the established use of deep learning models to identify glioma genetic mutations and grading were selected, based on a Quality Assessment of Diagnostic Accuracy Studies 2 score of ≥9. The included studies provided the deep learning models used alongside their outcome measures, the number of patients, and the molecular markers for brain glioma classification. In 19 studies, the researchers determined that the deep learning model improved the clinical outcome and treatment protocol in patients with a brain tumor. In five studies, the authors determined the sensitivity of the deep learning model used, and in four studies, the authors determined the specificity of the models. Convolutional neural network models were used in 16 studies. In eight studies, the researchers examined glioma grading by using different deep learning models compared with other models. In this review, we found that deep learning models significantly improve the diagnostic and classification accuracy of brain tumors, particularly gliomas without the need for invasive methods. Most studies have presented validated results and can be used in clinical practice to improve patient care and prognosis.

Highlights

  • BackgroundGliomas arise from precursor or glial cells and account for 27% of all tumors and 80% of major brain malignant tumors

  • Preoperative brain Magnetic resonance imaging (MRI) is a useful, non-invasive imaging technique for the assessment of the histopathological grade of gliomas. Both dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) have been used prior to surgery to differentiate the grades of gliomas by using different quantitative parameters; relative cerebral blood volume is the most sensitive parameter [5]

  • All prospective and retrospective studies that examined neuro-oncology patients with glioma, glioma tumor grading, and mutations using MRI and Artificial intelligence (AI), Machine learning (ML), or Deep learning (DL) models as a major diagnostic tool were eligible for inclusion

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Summary

Introduction

Gliomas arise from precursor or glial cells and account for 27% of all tumors and 80% of major brain malignant tumors. Preoperative brain MRI is a useful, non-invasive imaging technique for the assessment of the histopathological grade of gliomas. Both dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) have been used prior to surgery to differentiate the grades of gliomas by using different quantitative parameters; relative cerebral blood volume (rCBV) is the most sensitive parameter [5]. Computer-aided diagnosis (CAD) using intensity-invariant MRI features has been proposed to grade gliomas by using quantitative image features such as histogram moment and texture analyses, which are practical to use in the clinical setting [6]. Gutman et al [7] developed a comprehensive subjective MRI feature called Visually AcceSAble Rembrandt Images (VASARI) to predict overall survival and correlate it with different genomic biomarkers

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