Abstract

According to a classification of central nervous system tumors by the World Health Organization, diffuse gliomas are classified into grade 2, 3, and 4 gliomas in accordance with their aggressiveness. To quantitatively evaluate a tumor’s malignancy from brain magnetic resonance imaging, this study proposed a computer-aided diagnosis (CAD) system based on a deep convolutional neural network (DCNN). Gliomas from a multi-center database (The Cancer Imaging Archive) composed of a total of 30 grade 2, 43 grade 3, and 57 grade 4 gliomas were used for the training and evaluation of the proposed CAD. Using transfer learning to fine-tune AlexNet, a DCNN, its internal layers, and parameters trained from a million images were transferred to learn how to differentiate the acquired gliomas. Data augmentation was also implemented to increase possible spatial and geometric variations for a better training model. The transferred DCNN achieved an accuracy of 97.9% with a standard deviation of ±1% and an area under the receiver operation characteristics curve (Az) of 0.9991 ± 0, which were superior to handcrafted image features, the DCNN without pretrained features, which only achieved a mean accuracy of 61.42% with a standard deviation of ±7% and a mean Az of 0.8222 ± 0.07, and the DCNN without data augmentation, which was the worst with a mean accuracy of 59.85% with a standard deviation ±16% and a mean Az of 0.7896 ± 0.18. The DCNN with pretrained features and data augmentation can accurately and efficiently classify grade 2, 3, and 4 gliomas. The high accuracy is promising in providing diagnostic suggestions to radiologists in the clinic.

Highlights

  • Diffuse gliomas, the most common primary central nervous system (CNS) neoplasm, are formed of tumor cells that display differentiation of glial cells

  • Classification of tumors of the CNS [1,2], diffuse gliomas are graded according to their malignant

  • By evaluating the 10-fold differentiating grade 2 gliomas from the others achieved an accuracy of 98.7%, a sensitivity of 96.9%, cross-validation, the transferred deep convolutional neural network (DCNN) achieved a mean accuracy of 97.9% with an SD of ±1% and and a specificity of 99.2%

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Summary

Introduction

The most common primary central nervous system (CNS) neoplasm, are formed of tumor cells that display differentiation of glial cells. Classification of tumors of the CNS [1,2], diffuse gliomas are graded according to their malignant. Patients with diffuse gliomas of lower grades (grades 2 and 3). Glioblastoma multiforme (GBM) is the most aggressive tumor type (WHO grade 4) with dismal prognoses despite advances in various aspects of its clinical management [4]. Since therapeutic strategies for the various grades are not identical [5], distinguishing the different grades of diffuse gliomas is a critical issue in clinical settings. Since the definitions are semiquantitative and subjective [6,7], histopathological analyses sometimes result in ambiguity in glioma grading. Previous reports revealed that the heterogeneous expressions of cellular features may result in misgrading in up to one-third of cases with unguided surgical tissue sampling [7,8,9,10,11]

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