Neurosurgery; Neuropathology; Neuroradiology
BACKGROUND: Genetic profiling represents the future of neuro-oncology but suffers from inadequate biopsies in heterogeneous tumors like Glioblastoma (GBM). Contrast-enhanced MRI (CE-MRI) targets enhancing core (ENH) but yields adequate tumor in only ~60% of cases. Further, CE-MRI poorly localizes infiltrative tumor within surrounding non-enhancing parenchyma, or brain-around-tumor (BAT), despite the importance of characterizing this tumor segment, which universally recurs. In this study, we use multiple texture analysis and machine learning (ML) algorithms to analyze multi-parametric MRI, and produce new images indicating tumor-rich targets in GBM.
METHODS: We recruited primary GBM patients undergoing image-guided biopsies and acquired pre-operative MRI: CE-MRI, Dynamic-Susceptibility-weighted-Contrast-enhanced-MRI, and Diffusion Tensor Imaging. Following image coregistration and region of interest placement at biopsy locations, we compared MRI metrics and regional texture with histologic diagnoses of high- vs low-tumor content (≥80% vs
RESULTS: We collected 82 biopsies from 18 GBMs throughout ENH and BAT. The MRI-based model achieved 85% cross-validated accuracy to diagnose high- vs low-tumor in the training set (60 biopsies, 11 patients). The model achieved 81.8% accuracy in the validation set (22 biopsies, 7 patients).
CONCLUSION: Multi-parametric MRI and texture analysis can help characterize and visualize GBM's spatial histologic heterogeneity to identify regional tumor-rich biopsy targets.
Medical Subject Headings
Algorithms; Contrast Media; Diffusion Tensor Imaging; Glioblastoma; Humans; Image Interpretation, Computer-Assisted; Image-Guided Biopsy; Machine Learning; Magnetic Resonance Imaging; Radiography
Digital Object Identifier (DOI)
Hu, Leland S; Ning, Shuluo; Eschbacher, Jennifer M; Gaw, Nathan; Dueck, Amylou C; Smith, Kris A; Nakaji, Peter; Plasencia, Jonathan; Ranjbar, Sara; Price, Stephen J; Tran, Nhan; Loftus, Joseph; Jenkins, Robert; O'Neill, Brian P; Elmquist, William; Baxter, Leslie C; Gao, Fei; Frakes, David; Karis, John P; Zwart, Christine; Swanson, Kristin R; Sarkaria, Jann; Wu, Teresa; Mitchell, J Ross; and Li, Jing, "Multi-Parametric MRI and Texture Analysis to Visualize Spatial Histologic Heterogeneity and Tumor Extent in Glioblastoma." (2015). Neurosurgery. 772.