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Prognostic and Predictive Value of Integrated Qualitative and Quantitative Magnetic Resonance Imaging Analysis in Glioblastoma

Title: Prognostic and Predictive Value of Integrated Qualitative and Quantitative Magnetic Resonance Imaging Analysis in Glioblastoma
Authors: Maikel Verduin; Sergey Primakov; Inge Compter; Henry C. Woodruff; Sander M. J. van Kuijk; Bram L. T. Ramaekers; Maarten te Dorsthorst; Elles G. M. Revenich; Mark ter Laan; Sjoert A. H. Pegge; Frederick J. A. Meijer; Jan Beckervordersandforth; Ernst Jan Speel; Benno Kusters; Wendy W. J. de Leng; Monique M. Anten; Martijn P. G. Broen; Linda Ackermans; Olaf E. M. G. Schijns; Onno Teernstra; Koos Hovinga; Marc A. Vooijs; Vivianne C. G. Tjan-Heijnen; Danielle B. P. Eekers; Alida A. Postma; Philippe Lambin; Ann Hoeben
Source: Cancers, Vol 13, Iss 4, p 722 (2021)
Publisher Information: MDPI AG
Publication Year: 2021
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: glioblastoma; radiomics; MRI; prognosis; prediction; machine learning; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; RC254-282
Description: Glioblastoma (GBM) is the most malignant primary brain tumor for which no curative treatment options exist. Non-invasive qualitative (Visually Accessible Rembrandt Images (VASARI)) and quantitative (radiomics) imaging features to predict prognosis and clinically relevant markers for GBM patients are needed to guide clinicians. A retrospective analysis of GBM patients in two neuro-oncology centers was conducted. The multimodal Cox-regression model to predict overall survival (OS) was developed using clinical features with VASARI and radiomics features in isocitrate dehydrogenase ( IDH )-wild type GBM. Predictive models for IDH -mutation, 06-methylguanine-DNA-methyltransferase ( MGMT )-methylation and epidermal growth factor receptor ( EGFR ) amplification using imaging features were developed using machine learning. The performance of the prognostic model improved upon addition of clinical, VASARI and radiomics features, for which the combined model performed best. This could be reproduced after external validation (C-index 0.711 95% CI 0.64–0.78) and used to stratify Kaplan–Meijer curves in two survival groups ( p -value < 0.001). The predictive models performed significantly in the external validation for EGFR amplification (area-under-the-curve (AUC) 0.707, 95% CI 0.582–8.25) and MGMT -methylation (AUC 0.667, 95% CI 0.522–0.82) but not for IDH -mutation (AUC 0.695, 95% CI 0.436–0.927). The integrated clinical and imaging prognostic model was shown to be robust and of potential clinical relevance. The prediction of molecular markers showed promising results in the training set but could not be validated after external validation in a clinically relevant manner. Overall, these results show the potential of combining clinical features with imaging features for prognostic and predictive models in GBM, but further optimization and larger prospective studies are warranted.
Document Type: article in journal/newspaper
Language: English
Relation: https://www.mdpi.com/2072-6694/13/4/722; https://doaj.org/toc/2072-6694; https://doaj.org/article/f4f34d3d094745acb5e1e629272e2805
DOI: 10.3390/cancers13040722
Availability: https://doi.org/10.3390/cancers13040722; https://doaj.org/article/f4f34d3d094745acb5e1e629272e2805
Accession Number: edsbas.BD834058
Database: BASE