Abstract

Purpose: The aim of this study was to test whether radiomics-based machine learning can enable the better differentiation between glioblastoma (GBM) and anaplastic oligodendroglioma (AO).Methods: This retrospective study involved 126 patients histologically diagnosed as GBM (n = 76) or AO (n = 50) in our institution from January 2015 to December 2018. A total number of 40 three-dimensional texture features were extracted from contrast-enhanced T1-weighted images using LIFEx package. Six diagnostic models were established with selection methods and classifiers. The optimal radiomics features were separately selected into three datasets with three feature selection methods [distance correlation, least absolute shrinkage and selection operator (LASSO), and gradient boosting decision tree (GBDT)]. Then datasets were separately adopted into linear discriminant analysis (LDA) and support vector machine (SVM) classifiers. Specificity, sensitivity, accuracy, and area under curve (AUC) of each model were calculated to evaluate their diagnostic performances.Results: The diagnostic performance of machine learning models was superior to human readers. Both classifiers showed promising ability in discrimination with AUC more than 0.900 when combined with suitable feature selection method. For LDA-based models, the AUC of models were 0.986, 0.994, and 0.970 in the testing group, respectively. For the SVM-based models, the AUC of models were 0.923, 0.817, and 0.500 in the testing group, respectively. The over-fitting model was GBDT + SVM, suggesting that this model was too volatile that unsuitable for classification.Conclusion: This study indicates radiomics-based machine learning has the potential to be utilized in clinically discriminating GBM from AO.

Highlights

  • High-grade gliomas, the most common malignant solidary brain tumors in adults, are traditionally classified into anaplastic oligodendroglioma (AO), anaplastic astrocytoma (AA), and Glioblastoma (GBM) [1, 2]

  • The aim of this study was to test whether radiomics-based machine learning can enable the better differentiation between glioblastoma (GBM) and anaplastic oligodendroglioma (AO)

  • The optimal radiomics features were separately selected into three datasets with three feature selection methods [distance correlation, least absolute shrinkage and selection operator (LASSO), and gradient boosting decision tree (GBDT)]

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Summary

Introduction

High-grade gliomas, the most common malignant solidary brain tumors in adults, are traditionally classified into anaplastic oligodendroglioma (AO), anaplastic astrocytoma (AA), and Glioblastoma (GBM) [1, 2]. The early diagnosis of GBM and AO is clinically challenging but necessary due to their different treatment choice as well as the therapeutic responsiveness and patient survival [3]. As for GBM extended resection is recommended to increase patient survival, whereas for AO this strategy lacks solid evidence [4,5,6]. The treatment after surgery is different as well. For GBM, standardized therapy after surgery recommended by NCCN guidelines is standard brain radiation therapy (RT) + concurrent temozolomide (TMZ) followed by adjuvant chemotherapy [7]. While for AO, it is recommended to use fractionated external beam RT together with neoadjuvant or adjuvant PCV (procarbazine, lomustine, and vincristine) regarding the specific condition of each patient [7, 8]

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