AUTHOR=Ying Yu-Zhe , Cai Xiao-Hong , Yang Han , Huang Hua-Wei , Zheng Dao , Li Hao-Yi , Dong Ge-Hong , Wang Yong-Gang , Jiang Zhong-Li , An Zhu-Lin , Zhang Guo-Bin 

TITLE=Development and validation of a deep learning algorithm for discriminating glioma recurrence from radiation necrosis on MRI

JOURNAL=Frontiers in Oncology

VOLUME=Volume 15 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1573700

DOI=10.3389/fonc.2025.1573700

ISSN=2234-943X

ABSTRACT=PurposeAccurate differentiation between glioma recurrence and radiation necrosis is critical for the management of patients suspected of glioma recurrence following radiation therapy. This study aims to develop a deep learning-based methodology for automated discrimination between glioma recurrence and radiation necrosis using routine magnetic resonance imaging (MRI) scans.MethodWe retrospectively investigated 234 patients who underwent radiotherapy after glioma resection and presented with suspected recurrent lesions during follow-up MRI examinations. Routine 3D-MRI scans, including T1-weighted, T2-weighted, and contrast-enhanced T1 (T1ce) sequences, were acquired for each patient. Among the analyzed cases, 192 (82.1%) were pathologically confirmed as glioma recurrence, while 42 (17.9%) were diagnosed as radiation necrosis. Various Convolutional Neural Network (CNN) models were employed to learn radiological features indicative of glioma recurrence and radiation necrosis from the MRI scans. Performance evaluation metrics, such as sensitivity, specificity, accuracy, and area under the curve (AUC), were used to assess the models’ performance.ResultAmong the evaluated CNN models, ResNet10 demonstrated the highest sensitivity (0.78), specificity (0.94), accuracy (0.91), and an AUC value of 0.83. Additionally, the MresNet model achieved the highest specificity (0.980) but exhibited a relatively lower sensitivity (0.56). Another evaluated CNN model, Vgg16, showed a sensitivity of 0.56, specificity of 0.94, accuracy of 0.88, and an AUC value of 0.70.ConclusionThe proposed ResNet10 CNN model demonstrates promising performance on routine MRI scans, rendering it highly applicable in clinical settings. These findings contribute to enhancing the diagnostic accuracy for distinguishing between glioma recurrence and radiation necrosis using routine MRI.