Abstract

Purpose: The present study aimed to evaluate the performance of radiomics features in the preoperative prediction of epileptic seizure following surgery in patients with LGG.Methods: This retrospective study collected 130 patients with LGG. Radiomics features were extracted from the T2-weighted MR images obtained before surgery. Multivariable Cox-regression with two nested leave-one-out cross validation (LOOCV) loops was applied to predict the prognosis, and elastic net was used in each LOOCV loop to select the predictive features. Logistic models were then built with the selected features to predict epileptic seizures at two time points. Student's t-tests were then used to compare the logistic model predicted probabilities of developing epilepsy in the epilepsy and non-epilepsy groups. The t-test was used to identify features that differentiated patients with early-onset epilepsy from their late-onset counterparts.Results: Seventeen features were selected with the two nested LOOCV loops. The index of concordance (C-index) of the Cox model was 0.683, and the logistic model predicted probabilities of seizure were significantly different between the epilepsy and non-epilepsy groups at each time point. Moreover, one feature was found to be significantly different between the patients with early- or late-onset epilepsy.Conclusion: A total of 17 radiomics features were correlated with postoperative epileptic seizures in patients with LGG and one feature was a significant predictor of the time of epilepsy onset.

Highlights

  • Low-grade gliomas (LGGs) are slow-growing, infiltrative tumors frequently associated with seizures

  • Tumor location and the tumor volume could be the risk factors that may lead to postoperative epileptic seizure, we further investigated the correlation between the selected radiomics features with clinical factors

  • We aimed to evaluate the performance of the radiomics features in the pretreatment prediction of epileptic seizure after surgery in patients with LGG

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Summary

Introduction

Low-grade gliomas (LGGs) are slow-growing, infiltrative tumors frequently associated with seizures. Epilepsy seizure could be used as a clinical predictor for early tumor recurrence with LGGs [1]. The persistence of seizures in these patients may be associated with the worsening of their neurological, neuropsychological, and psychological status, reducing their quality of life [2, 3]. The reported recurrence of epilepsy in 20–40% of patients demonstrates that the current conventional treatment strategy used to address glioma-related epilepsy, including antiepileptic drugs (AEDs) and anti-tumor therapies, remain unsatisfactory [4,5,6]. The preoperative prediction of epilepsy seizures following surgery could help clinicians evaluate the risk of patients for epilepsy after surgery, further to make decision of individualized treatment strategy, which was significant for clinical treatment

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