Korean J Radiol.  2021 Sep;22(9):1514-1524. 10.3348/kjr.2020.1433.

Prediction of Prognosis in Glioblastoma Using Radiomics Features of Dynamic Contrast-Enhanced MRI

• Pak E
• Choi KS
• Choi SH
• Park CK
• Kim TM
• Park SH
• Lee JH
• Lee ST
• Hwang I
• Yoo RE
• Kang KM
• Yun TJ
• Kim JH
• Sohn CH

• KMID: 2519437
• DOI: http://doi.org/10.3348/kjr.2020.1433

Abstract

Objective
To develop a radiomics risk score based on dynamic contrast-enhanced (DCE) MRI for prognosis prediction in patients with glioblastoma.
Materials and Methods
One hundred and fifty patients (92 male [61.3%]; mean age ± standard deviation, 60.5 ± 13.5 years) with glioblastoma who underwent preoperative MRI were enrolled in the study. Six hundred and forty-two radiomic features were extracted from volume transfer constant (K^trans), fractional volume of vascular plasma space (V_p), and fractional volume of extravascular extracellular space (V_e) maps of DCE MRI, wherein the regions of interest were based on both T1-weighted contrast-enhancing areas and non-enhancing T2 hyperintense areas. Using feature selection algorithms, salient radiomic features were selected from the 642 features. Next, a radiomics risk score was developed using a weighted combination of the selected features in the discovery set (n = 105); the risk score was validated in the validation set (n = 45) by investigating the difference in prognosis between the “radiomics risk score” groups. Finally, multivariable Cox regression analysis for progression-free survival was performed using the radiomics risk score and clinical variables as covariates.
Results
16 radiomic features obtained from non-enhancing T2 hyperintense areas were selected among the 642 features identified. The radiomics risk score was used to stratify high- and low-risk groups in both the discovery and validation sets (both p < 0.001 by the log-rank test). The radiomics risk score and presence of isocitrate dehydrogenase (IDH) mutation showed independent associations with progression-free survival in opposite directions (hazard ratio, 3.56; p = 0.004 and hazard ratio, 0.34; p = 0.022, respectively).
Conclusion
We developed and validated the “radiomics risk score” from the features of DCE MRI based on non-enhancing T2 hyperintense areas for risk stratification of patients with glioblastoma. It was associated with progression-free survival independently of IDH mutation status.

Keyword

Glioblastoma; Progression; Dynamic contrast enhanced MRI; K^trans; V_e; V_p; Radiomics