Original Research ARTICLE
“A Multi-Parametric MRI-Based Radiomics Signature and a Practical ML Model for Stratifying Glioblastoma Patients Based on Survival towards Precision Oncology”
- 1Al-Neelain University, Sudan
Purpose: Predicting patient survival outcome is recognized as key importance to clinicians in oncology toward determining an ideal course of treatment and patient management. This study applies radiomics analysis on pre-operative multi-parametric MRI of patients with glioblastoma from multi-institution to identify a signature and a practical machine learning model for stratifying patients into groups based on overall survival.
Methods: This study included 163 patients’ data with glioblastoma, collected by BRATS 2018 Challenge from multiple institutions. In this proposed method, a set of 147 radiomics image features were extracted locally from three tumor sub-regions on standardized pre-operative multi-parametric MR images. LASSO regression was applied for identifying an informative subset of chosen features whereas a Cox model used to obtain the coefficients of those selected features. Then, a radiomics signature model of 9 features was constructed on the discovery set and it performance was evaluated for patients stratification into short- (< 10 months), medium- (10 – 15 months), and long-survivors (> 15 months) groups. Eight ML classification models, trained and then cross-validated, were tested to assess a range of survival prediction performance as a function of the choice of features.
Results: The proposed mpMRI radiomics signature model had a statistically significant association with survival (P < 0.001) in the training set, but was not confirmed (P = 0.110) in the validation cohort. Its performance in the validation set had a sensitivity of 0.476 (short-), 0.231 (medium-), and 0.600 (long-survivors), and specificity of 0.667 (short-), 0.732 (medium-), and 0.794 (long-survivors). Among the tested ML classifiers, the ensemble learning model’s results showed superior performance in predicting the survival classes, with an overall accuracy of 57.8 % and AUC of 0.81 for short-, 0.47 for medium-, and 0.72 for long-survivors using the LASSO selected features combined with clinical factors.
Conclusion: A derived GLCM feature, representing intra-tumoral inhomogeneity, was found to have a high association with survival. Clinical factors, when added to the radiomics image features, boosted the performance of the ML classification model in predicting individual glioblastoma patient’s survival prognosis, which can improve prognostic quality a further step towards precision oncology.
Keywords: Glioblastoma Multiforme, MRI, Radiomics analysis, Patient’s Survival Prediction, machine learning, precision oncology
Received: 30 Apr 2019;
Accepted: 09 Aug 2019.
Edited by:Spyridon Bakas, University of Pennsylvania, United States
Reviewed by:Ahmad Chaddad, McGill University Health Centre, Canada
Gaurav Shukla, University of Pennsylvania, United States
Copyright: © 2019 Osman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mx. Alexander F. Osman, Al-Neelain University, Khartoum, Sudan, firstname.lastname@example.org