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. 2016 Sep;2(3):223-228.
doi: 10.18383/j.tom.2016.00250.

Magnetic Resonance Imaging-Based Radiomic Profiles Predict Patient Prognosis in Newly Diagnosed Glioblastoma Before Therapy

Sean D McGarry  1 , Sarah L Hurrell  1 , Amy L Kaczmarowski  1 , Elizabeth J Cochran  2 , Jennifer Connelly  3 , Scott D Rand  1 , Kathleen M Schmainda  4 , Peter S LaViolette  4
Affiliations

Magnetic Resonance Imaging-Based Radiomic Profiles Predict Patient Prognosis in Newly Diagnosed Glioblastoma Before Therapy

Sean D McGarry et al. Tomography. 2016 Sep.

Abstract

Magnetic resonance imaging (MRI) is used to diagnose and monitor brain tumors. Extracting additional information from medical imaging and relating it to a clinical variable of interest is broadly defined as radiomics. Here, multiparametric MRI radiomic profiles (RPs) of de novo glioblastoma (GBM) brain tumors is related with patient prognosis. Clinical imaging from 81 patients with GBM before surgery was analyzed. Four MRI contrasts were aligned, masked by margins defined by gadolinium contrast enhancement and T2/fluid attenuated inversion recovery hyperintensity, and contoured based on image intensity. These segmentations were combined for visualization and quantification by assigning a 4-digit numerical code to each voxel to indicate the segmented RP. Each RP volume was then compared with overall survival. A combined classifier was then generated on the basis of significant RPs and optimized volume thresholds. Five RPs were predictive of overall survival before therapy. Combining the RP classifiers into a single prognostic score predicted patient survival better than each alone (P < .005). Voxels coded with 1 RP associated with poor prognosis were pathologically confirmed to contain hypercellular tumor. This study applies radiomic profiling to de novo patients with GBM to determine imaging signatures associated with poor prognosis at tumor diagnosis. This tool may be useful for planning surgical resection or radiation treatment margins.

Keywords: autopsy; glioblastoma; prognosis; radiomics.

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Figures

Figure 1.
Figure 1.
Individual region of interest (ROI) segmentation of 4 image contrasts (Left). Combination of individual segmentation to generate radiomic profile (RP) map (Right).
Figure 2.
Figure 2.
Profiles correlated with survival isolated and overlaid on FLAIR (2133 in FTU) or T1+C (all others).
Figure 4.
Figure 4.
RP (red) and boundaries of tissue sample (white) overlaid on fluid attenuated inversion recovery (FLAIR) image (A). Hypercellular tumor in areas of histology indicated by RP 1133 (B).
Figure 3.
Figure 3.
Survival vs prognostic score for scores of 0–6 (Left). Low (0–2) and high (3–5) risk group vs survival (Right).
Figure 5.
Figure 5.
Low-risk patient with good predicted prognosis survives longer than average survival time (Left). High-risk patient with poor predicted prognosis dies shortly after diagnosis (Right). Low-risk profiles (blue) and high-risk profiles above threshold shown in Table 1 (orange) and high-risk profile below threshold (green) (Bottom).
See this image and copyright information in PMC

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