Differentiation of recurrent glioblastoma from radiation necrosis using diffusion radiomics with machine learning model development and external validation

Sci Rep. 2021 Feb 3;11(1):2913. doi: 10.1038/s41598-021-82467-y.

Abstract

The purpose of this study was to establish a high-performing radiomics strategy with machine learning from conventional and diffusion MRI to differentiate recurrent glioblastoma (GBM) from radiation necrosis (RN) after concurrent chemoradiotherapy (CCRT) or radiotherapy. Eighty-six patients with GBM were enrolled in the training set after they underwent CCRT or radiotherapy and presented with new or enlarging contrast enhancement within the radiation field on follow-up MRI. A diagnosis was established either pathologically or clinicoradiologically (63 recurrent GBM and 23 RN). Another 41 patients (23 recurrent GBM and 18 RN) from a different institution were enrolled in the test set. Conventional MRI sequences (T2-weighted and postcontrast T1-weighted images) and ADC were analyzed to extract 263 radiomic features. After feature selection, various machine learning models with oversampling methods were trained with combinations of MRI sequences and subsequently validated in the test set. In the independent test set, the model using ADC sequence showed the best diagnostic performance, with an AUC, accuracy, sensitivity, specificity of 0.80, 78%, 66.7%, and 87%, respectively. In conclusion, the radiomics models models using other MRI sequences showed AUCs ranging from 0.65 to 0.66 in the test set. The diffusion radiomics may be helpful in differentiating recurrent GBM from RN..

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Brain / diagnostic imaging
  • Brain / pathology
  • Brain / radiation effects
  • Brain / surgery
  • Chemoradiotherapy, Adjuvant / adverse effects*
  • Chemoradiotherapy, Adjuvant / methods
  • Diffusion Magnetic Resonance Imaging / methods
  • Female
  • Glioblastoma / diagnosis*
  • Glioblastoma / pathology
  • Glioblastoma / therapy
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Machine Learning
  • Male
  • Middle Aged
  • Necrosis / diagnosis
  • Necrosis / etiology
  • Necrosis / pathology
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / pathology
  • ROC Curve
  • Radiation Injuries / diagnosis*
  • Radiation Injuries / etiology
  • Radiation Injuries / pathology
  • Retrospective Studies
  • Temozolomide / administration & dosage
  • Temozolomide / adverse effects

Substances

  • Temozolomide