Abstract

Purpose Preoperative prediction of isocitrate dehydrogenase 1 (IDH1) mutation in lower-grade gliomas (LGGs) is crucial for clinical decision-making. This study aimed to examine the predictive value of a machine learning approach using qualitative and quantitative MRI features to identify the IDH1 mutation in LGGs. Materials and Methods A total of 102 LGG patients were allocated to training (n = 67) and validation (n = 35) cohorts and were subject to Visually Accessible Rembrandt Images (VASARI) feature extraction (23 features) from conventional multimodal MRI and radiomics feature extraction (56 features) from apparent diffusion coefficient maps. Feature selection was conducted using the maximum Relevance Minimum Redundancy method and 0.632+ bootstrap method. A machine learning model to predict IDH1 mutation was then established using a random forest classifier. The predictive performance was evaluated using receiver operating characteristic (ROC) curves. Results After feature selection, the top 5 VASARI features were enhancement quality, deep white matter invasion, tumor location, proportion of necrosis, and T1/FLAIR ratio, and the top 10 radiomics features included 3 histogram features, 3 gray-level run-length matrix features, and 3 gray-level size zone matrix features and one shape feature. Using the optimal VASARI or radiomics feature sets for IDH1 prediction, the trained model achieved an area under the ROC curve (AUC) of 0.779 ± 0.001 or 0.849 ± 0.008 on the validation cohort, respectively. The fusion model that integrated outputs of both optimal VASARI and radiomics models improved the AUC to 0.879. Conclusion The proposed machine learning approach using VASARI and radiomics features can predict IDH1 mutation in LGGs.

Highlights

  • Diffuse lower-grade gliomas (LGGs; World Health Organization (WHO) grade II or III) are infiltrative neoplasms which account for about 33%-45% of all adult gliomas [1, 2]

  • We aimed to develop a machine learning approach based on VASARI and Apparent diffusion coefficient (ADC) radiomics features to characterize the isocitrate dehydrogenase 1 (IDH1) mutation status in LGGs

  • 50 (49%) and 52 (51%) patients were confirmed with IDH1-mutant and IDH1-wildtype LGG, respectively

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Summary

Introduction

Diffuse lower-grade gliomas (LGGs; World Health Organization (WHO) grade II or III) are infiltrative neoplasms which account for about 33%-45% of all adult gliomas [1, 2]. LGGs are usually less aggressive with better treatment response and prolonged prognosis compared with glioblastomas (WHO grade IV), many cases eventually progress to glioblastoma. Previous studies have shown that the high tumor heterogeneity in clinical behavior depends on genetics more than histology [1,2,3]. The 2016 WHO classification of Tumors of the Central Nervous System integrates molecular biomarkers with histology for glioma diagnosis [4]. Isocitrate dehydrogenase (IDH) is one of the most important molecular biomarkers in gliomagenesis.

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