Abstract

PurposeTo investigate the diagnostic ability of radiomics-based machine learning in differentiating atypical low-grade astrocytoma (LGA) from anaplastic astrocytoma (AA).MethodsThe current study involved 175 patients diagnosed with LGA (n = 95) or AA (n = 80) and treated in the Neurosurgery Department of West China Hospital from April 2010 to December 2019. Radiomics features were extracted from pre-treatment contrast-enhanced T1 weighted imaging (T1C). Nine diagnostic models were established with three selection methods [Distance Correlation, least absolute shrinkage, and selection operator (LASSO), and Gradient Boosting Decision Tree (GBDT)] and three classification algorithms [Linear Discriminant Analysis (LDA), Support Vector Machine (SVM), and random forest (RF)]. The sensitivity, specificity, accuracy, and areas under receiver operating characteristic curve (AUC) of each model were calculated. Diagnostic ability of each model was evaluated based on these indexes.ResultsNine radiomics-based machine learning models with promising diagnostic performances were established. For LDA-based models, the optimal one was the combination of LASSO + LDA with AUC of 0.825. For SVM-based modes, Distance Correlation + SVM represented the most promising diagnostic performance with AUC of 0.808. And for RF-based models, Distance Correlation + RF were observed to be the optimal model with AUC of 0.821.ConclusionRadiomic-based machine-learning has the potential to be utilized in differentiating atypical LGA from AA with reliable diagnostic performance.

Highlights

  • Astrocytoma is one of the most common intracranial tumors characterized by rapid evolvement emphasizing the challenge for early diagnosis and intervention [1]

  • The meta-analysis by Abrigo and colleagues included seven studies with 115 solid and non-enhancing glioma patients, and evaluated the diagnostic capability of cerebral blood volume (CBV), which was expressed as ratio of tumoral CBV to normal white matter CBV, in differentiating low-grade gliomas and high-grade gliomas [11]

  • Results of this meta-analysis indicated that 7% to 34% low-grade glioma cases may be misdiagnosed as high-grade gliomas, and around half of high-grade glioma cases may be misdiagnosed as low-grade gliomas by a rCBV threshold of 1.75 [11]

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Summary

Introduction

Astrocytoma is one of the most common intracranial tumors characterized by rapid evolvement emphasizing the challenge for early diagnosis and intervention [1]. The meta-analysis by Abrigo and colleagues included seven studies with 115 solid and non-enhancing glioma patients, and evaluated the diagnostic capability of cerebral blood volume (CBV), which was expressed as ratio of tumoral CBV to normal white matter CBV (rCBV), in differentiating low-grade gliomas and high-grade gliomas [11]. Results of this meta-analysis indicated that 7% to 34% low-grade glioma cases may be misdiagnosed as high-grade gliomas, and around half of high-grade glioma cases may be misdiagnosed as low-grade gliomas by a rCBV threshold of 1.75 [11]. This highlights the urgent requirement of novel technology to make the interpretation of MRI more accurate and reliable

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