Radiomics for diagnosis and assessing brain diseases: an approach based on texture analysis on magnetic resonance imaging

Abstract

Over the last years, researchers have attempted to exploit the information provided by medical images through the evaluation of numerous imaging quantitative parameters in order to help clinicians with the diagnosis and assessment of many lesions and diseases. This practice has been recently named as radiomics. Texture analysis supply a wide range of features that allow quantifying the distinctive heterogeneity of different tissues, especially when obtained from magnetic resonance imaging (MRI). With this in mind, we decided to study the possibilities of texture features from MRI in order to characterize several disorders that affect the human brain. The potential of texture features was analyzed with various machine learning approaches, involving different classifiers and feature selection methods so as to find the optimal model to accomplish each specific task. In this thesis, the radiomics methodology was used to perform four independent projects. In the first project, we studied the differentiation between glioblastomas (GBMs) and brain metastases (BMs) in conventional MRI. Sometimes these types of brain tumors can be misdiagnosed since they may present a similar radiological profile and the clinical data may be inconclusive. With the aim of avoiding exhaustive and invasive procedures, we studied the discriminatory power of a large amount of 2D texture features extracted from baseline original and filtered T1-weighted images. The results suggest that 2D texture features provide some heterogeneity information of GBMs and BMs that can help in their accurate discernment when using the proper machine learning approach. In the second project, we analyzed the classification of BMs by their primary site of origin in baseline MRI. A percentage of patients are diagnosed with BM as the first manifestation of an unknown primary tumor. In order to detect the primary tumor in a faster non-invasive way, we examined the capability of 2D and 3D texture analysis to differentiate BMs derived from the most common primary tumors (lung cancer, breast cancer and melanoma) in T1-weighted images. The results showed that high accuracy was achieved when using a reduced set of 3D descriptors to differentiate lung cancer BMs from breast cancer and melanoma BMs. In the third project, we evaluated the hippocampus MRI profile of Alzheimer's disease (AD) patients to identify the different stages of the disease. The current criteria for diagnosing AD require the presence of relevant cognitive deficits. With the purpose of establishing new biomarkers to detect AD in its early stages, we evaluated a set of 2D and 3D texture features extracted from MRI scans of the hippocampus of patients with advanced AD, early mild cognitive impairment and cognitive normality. Many 3D texture parameters resulted to be statistically significant to differentiate between AD patients and subjects from the other two populations. When combining these 3D parameters with machine learning techniques, high accuracy was obtained. In the fourth project, we attempted to characterize the heterogeneity patterns of ischemic stroke in structural MRI. In brain MRI of older individuals, some pathological processes present similar imaging characteristics, like in the case of stroke lesions and white matter hyperintensities (WMH) of diverse natures. Given that stroke effects are present not only in the affected region, but also in unaffected tissue, we investigated the feasibility of 3D texture features from WMH, normal-appearing white matter and subcortical structures to differentiate individuals who had a lacunar or cortical stroke visible on conventional brain MRI (T1-weighted, T2-weighted and FLAIR images) from subjects who did not. Texture features were not useful to differentiate between post-acute cortical and lacunar strokes, but promising results were achieved for discerning between patients presenting an old stroke and normal-ageing patients who never had a stroke.