Abstract

PurposeMedulloblastoma (MB) is a highly malignant pediatric brain tumor. In the latest classification, medulloblastoma is divided into four distinct groups: wingless (WNT), sonic hedgehog (SHH), Group 3, and Group 4. We analyzed the magnetic resonance imaging radiomics features to find the imaging surrogates of the 4 molecular subgroups of MB.Material and methodsFrozen tissue, imaging data, and clinical data of 38 patients with medulloblastoma were included from Taipei Medical University Hospital and Taipei Veterans General Hospital. Molecular clustering was performed based on the gene expression level of 22 subgroup-specific signature genes. A total 253 magnetic resonance imaging radiomic features were generated from each subject for comparison between different molecular subgroups.ResultsOur cohort consisted of 7 (18.4%) patients with WNT medulloblastoma, 12 (31.6%) with SHH tumor, 8 (21.1%) with Group 3 tumor, and 11 (28.9%) with Group 4 tumor. 8 radiomics gray-level co-occurrence matrix texture (GLCM) features were significantly different between 4 molecular subgroups of MB. In addition, for tumors with higher values in a gray-level run length matrix feature—Short Run Low Gray-Level Emphasis, patients have shorter survival times than patients with low values of this feature (p = 0.04). The receiver operating characteristic analysis revealed optimal performance of the preliminary prediction model based on GLCM features for predicting WNT, Group 3, and Group 4 MB (area under the curve = 0.82, 0.72, and 0.78, respectively).ConclusionThe preliminary result revealed that 8 contrast-enhanced T1-weighted imaging texture features were significantly different between 4 molecular subgroups of MB. Together with the prediction models, the radiomics features may provide suggestions for stratifying patients with MB into different risk groups.

Highlights

  • Medulloblastoma (MB) is the most common primary malignant brain tumor in children and is currently treated on the basis of pathological and clinicoradiological risk stratification [1]

  • A total 253 magnetic resonance imaging radiomic features were generated from each subject for comparison between different molecular subgroups

  • Our cohort consisted of 7 (18.4%) patients with WNT medulloblastoma, 12 (31.6%) with sonic hedgehog (SHH) tumor, 8 (21.1%) with Group 3 tumor, and 11 (28.9%) with Group 4 tumor. 8 radiomics gray-level co-occurrence matrix texture (GLCM) features were significantly different between 4 molecular subgroups of MB

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Summary

Introduction

Medulloblastoma (MB) is the most common primary malignant brain tumor in children and is currently treated on the basis of pathological and clinicoradiological risk stratification [1]. Current therapeutic options have debilitating effects on developing children, highlighting the need for molecularly targeted treatments with reduced toxicity. Research conducted over the past years has identified four distinct molecular variants, namely wingless (WNT), sonic hedgehog (SHH), Group 3, and Group 4, each with different demographic, and genomic characteristics [3,4]. Improved knowledge of signaling pathways and important oncogenic drivers in these subgroups has elucidated the reasons for suboptimal clinical outcomes and therapeutic resistance. These findings have ushered in a new era of therapeutic optimism, with latest clinical trials pursued on the basis of the molecular classification of MB. The heterogeneous spatial distribution of genomic features makes unguided surgical biopsies prone to sampling errors, which may result in misclassification [5,6]

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