Radiomics has potential advantages in the noninvasive histopathological and molecular diagnosis of gliomas. We aimed to develop a novel image signature (IS)-based radiomics model to achieve multilayered preoperative diagnosis and prognostic stratification of gliomas. Herein, we established three separate case cohorts, consisting of 655 glioma patients, and carried out a retrospective study. Image and clinical data of three cohorts were used for training (N = 188), cross-validation (N = 411), and independent testing (N = 56) of the IS model. All tumors were segmented from magnetic resonance (MR) images by the 3D U-net, followed by extraction of high-throughput network features, which were referred to as IS. IS was then used to perform noninvasive histopathological diagnosis and molecular subtyping. Moreover, a new IS-based clustering method was applied for prognostic stratification in IDH-wild-type lower-grade glioma (IDHwt LGG) and triple-negative glioblastoma (1p19q retain/IDH wild-type/TERTp-wild-type GBM). The average accuracies of histological diagnosis and molecular subtyping were 89.8 and 86.1% in the cross-validation cohort, while these numbers reached 83.9 and 80.4% in the independent testing cohort. IS-based clustering method was demonstrated to successfully divide IDHwt LGG into two subgroups with distinct median overall survival time (48.63 vs 38.27 months respectively, P = 0.023), and two subgroups in triple-negative GBM with different median OS time (36.8 vs 18.2 months respectively, P = 0.013). Our findings demonstrate that our novel IS-based radiomics model is an effective tool to achieve noninvasive histo-molecular pathological diagnosis and prognostic stratification of gliomas. This IS model shows potential for future routine use in clinical practice.
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The authors would like to thank Xinhua Ding from the Department of Neurosurgery, Shanghai International Medical Center and Haixia Chen from the Department of Pathology, Shanghai International Medical Center for providing information on several glioma cases, their corresponding MR images and molecular data in this research.
The study was supported by the National Natural Science Foundation of China (91959127 and 81702471), National Natural Science Foundation of China (2015CB755500), Shanghai Municipal Science and Technology Major Project (No. 2018SHZDZX01), and ZJLab, Shanghai Municipal Health Commission Project (2018ZHYL0107).
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Luo, H., Zhuang, Q., Wang, Y. et al. A novel image signature-based radiomics method to achieve precise diagnosis and prognostic stratification of gliomas. Lab Invest (2020). https://doi.org/10.1038/s41374-020-0472-x