Deep learning-assisted radiomics facilitates multimodal prognostication for personalized treatment strategies in low-grade glioma
Philip Rauch, Harald Stefanits, Martin Aichholzer, Carlo Serra, D. Vorhauer, Helga Wagner, Peter Böhm, Sylvia Hartl, Ilja Manakov, Michael Sonnberger, E. Buckwar, Francisco Ruiz-Navarro, Kurtis Heil, M. Glöckel, Johannes Oberndorfer, Sabine Spiegl‐Kreinecker, Kathrin Aufschnaiter-Hießböck, Serge Weis, Annette Leibetseder, Wolfgang Thomae, Thomas Häuser, Christian Auer, S. Katletz, Andreas Gruber, Matthias Gmeiner
Abstract
Determining the optimal course of treatment for low grade glioma (LGG) patients is challenging and frequently reliant on subjective judgment and limited scientific evidence. Our objective was to develop a comprehensive deep learning assisted radiomics model for assessing not only overall survival in LGG, but also the likelihood of future malignancy and glioma growth velocity. Thus, we retrospectively included 349 LGG patients to develop a prediction model using clinical, anatomical, and preoperative MRI data. Before performing radiomics analysis, a U2-model for glioma segmentation was utilized to prevent bias, yielding a mean whole tumor Dice score of 0.837. Overall survival and time to malignancy were estimated using Cox proportional hazard models. In a postoperative model, we derived a C-index of 0.82 (CI 0.79-0.86) for the training cohort over 10 years and 0.74 (Cl 0.64-0.84) for the test cohort. Preoperative models showed a C-index of 0.77 (Cl 0.73-0.82) for training and 0.67 (Cl 0.57-0.80) test sets. Our findings suggest that we can reliably predict the survival of a heterogeneous population of glioma patients in both preoperative and postoperative scenarios. Further, we demonstrate the utility of radiomics in predicting biological tumor activity, such as the time to malignancy and the LGG growth rate.