Prediction of pseudoprogression and long-term outcome of vestibular schwannoma after Gamma Knife radiosurgery based on preradiosurgical MR radiomics

Huai-Che Yang; Chih-Chun Wu; Cheng-Chia Lee; Huai-En Huang; Wei-Kai Lee; Wen-Yuh Chung; Hsiu-Mei Wu; Wan-Yuo Guo; Yu-Te Wu; Chia-Feng Lu

doi:10.1016/j.radonc.2020.10.041

Prediction of pseudoprogression and long-term outcome of vestibular schwannoma after Gamma Knife radiosurgery based on preradiosurgical MR radiomics

Radiother Oncol. 2021 Feb:155:123-130. doi: 10.1016/j.radonc.2020.10.041. Epub 2020 Nov 5.

Authors

Huai-Che Yang¹, Chih-Chun Wu², Cheng-Chia Lee³, Huai-En Huang⁴, Wei-Kai Lee⁵, Wen-Yuh Chung¹, Hsiu-Mei Wu², Wan-Yuo Guo², Yu-Te Wu⁶, Chia-Feng Lu⁷

Affiliations

¹ Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
² School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Radiology, Taipei Veterans General Hospital, Taiwan.
³ Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
⁴ Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan; Department of Medical Imaging, Cheng-Hsin General Hospital, Taipei, Taiwan.
⁵ Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan.
⁶ Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan; Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.
⁷ Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan; Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan. Electronic address: alvin4016@ym.edu.tw.

PMID: 33161011
DOI: 10.1016/j.radonc.2020.10.041

Abstract

Background and purpose: Gamma Knife radiosurgery (GKRS) is a safe and effective treatment modality with a long-term tumor control rate over 90% for vestibular schwannoma (VS). However, numerous tumors may undergo a transient pseudoprogression during 6-18 months after GKRS followed by a long-term volume reduction. The aim of this study is to determine whether the radiomics analysis based on preradiosurgical MRI data could predict the pseudoprogression and long-term outcome of VS after GKRS.

Materials and methods: A longitudinal dataset of patients with VS treated by single GKRS were retrospectively collected. Overall 336 patients with no previous craniotomy for tumor removal and a median of 65-month follow-up period after radiosurgery were finally included in this study. In total 1763 radiomic features were extracted from the multiparameteric MRI data before GKRS followed by the machine-learning classification.

Results: We constructed a two-level machine-learning model to predict the long-term outcome and the occurrence of transient pseudoprogression after GKRS separately. The prediction of long-term outcome achieved an accuracy of 88.4% based on five radiomic features describing the variation of T2-weighted intensity and inhomogeneity of contrast enhancement in tumor. The prediction of transient pseudoprogression achieved an accuracy of 85.0% based on another five radiomic features associated with the inhomogeneous hypointensity pattern of contrast enhancement and the variation of T2-weighted intensity.

Conclusion: The proposed machine-learning model based on the preradiosurgical MR radiomics provides a potential to predict the pseudoprogression and long-term outcome of VS after GKRS, which can benefit the treatment strategy in clinical practice.

Keywords: Gamma Knife radiosurgery; Machine learning; Magnetic resonance image; Radiomics; Vestibular schwannoma.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Follow-Up Studies
Humans
Magnetic Resonance Imaging
Neuroma, Acoustic* / diagnostic imaging
Neuroma, Acoustic* / radiotherapy
Neuroma, Acoustic* / surgery
Radiosurgery*
Retrospective Studies
Treatment Outcome