Pediatric medulloblastomas (MBs) are the most common type of malignant brain tumors in children. They are among the most aggressive types of tumors due to their potential for metastasis. Although this disease was initially considered a single disease, pediatric MBs can be considerably heterogeneous. Current MB classification schemes are heavily reliant on histopathology. However, the classification of MB from histopathological images is a manual process that is expensive, time-consuming, and prone to error. Previous studies have classified MB subtypes using a single feature extraction method that was based on either deep learning or textural analysis. Here, we combine textural analysis with deep learning techniques to improve subtype identification using histopathological images from two medical centers. Three state-of-the-art deep learning models were trained with textural images created from two texture analysis methods in addition to the original histopathological images, enabling the proposed pipeline to benefit from both the spatial and textural information of the images. Using a relatively small number of features, we show that our automated pipeline can yield an increase in the accuracy of classification of pediatric MB compared with previously reported methods. A refined classification of pediatric MB subgroups may provide a powerful tool for individualized therapies and identification of children with increased risk of complications.
Keywords: artificial intelligence; brain tumors; classification; convolutional neural networks (CNN); deep learning; feature extraction; pediatric medulloblastoma subtypes; texture analysis.