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Differentiation of Pseudoprogression from True Progressionin Glioblastoma Patients after Standard Treatment: A Machine Learning Strategy Combinedwith Radiomics Features from T1-weighted Contrast-enhanced Imaging.


ABSTRACT:

Background

Based on conventional MRI images, it is difficult to differentiatepseudoprogression from true progressionin GBM patients after standard treatment, which isa critical issue associated with survival. The aim of this study was to evaluate the diagnostic performance of machine learning using radiomics modelfrom T1-weighted contrast enhanced imaging(T1CE) in differentiating pseudoprogression from true progression after standard treatment for GBM.

Methods

Seventy-sevenGBM patients, including 51 with true progression and 26 with pseudoprogression,who underwent standard treatment and T1CE, were retrospectively enrolled.Clinical information, including sex, age, KPS score, resection extent, neurological deficit and mean radiation dose, were also recorded collected for each patient. The whole tumor enhancementwas manually drawn on the T1CE image, and a total of texture 9675 features were extracted and fed to a two-step feature selection scheme. A random forest (RF) classifier was trained to separate the patients by their outcomes.The diagnostic efficacies of the radiomics modeland radiologist assessment were further compared by using theaccuracy (ACC), sensitivity and specificity.

Results

No clinical features showed statistically significant differences between true progression and pseudoprogression.The radiomic classifier demonstrated ACC, sensitivity, and specificity of 72.78%(95% confidence interval [CI]: 0.45,0.91), 78.36%(95%CI: 0.56,1.00) and 61.33%(95%CI: 0.20,0.82).The accuracy, sensitivity and specificity of three radiologists' assessment were66.23%(95% CI: 0.55,0.76), 61.50%(95% CI: 0.43,0.78) and 68.62%(95% CI: 0.55,0.80); 55.84%(95% CI: 0.45,0.66),69.25%(95% CI: 0.50,0.84) and 49.13%(95% CI: 0.36,0.62); 55.84%(95% CI: 0.45,0.66), 69.23%(95% CI: 0.50,0.84) and 47.06%(95% CI: 0.34,0.61), respectively.

Conclusion

T1CE-based radiomics showed better classification performance compared with radiologists' assessment.The radiomics modelwas promising in differentiating pseudoprogression from true progression.

SUBMITTER: Sun YZ 

PROVIDER: S-EPMC7860032 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Differentiation of Pseudoprogression from True Progressionin Glioblastoma Patients after Standard Treatment: A Machine Learning Strategy Combinedwith Radiomics Features from T<sub>1</sub>-weighted Contrast-enhanced Imaging.

Sun Ying-Zhi YZ   Yan Lin-Feng LF   Han Yu Y   Nan Hai-Yan HY   Xiao Gang G   Tian Qiang Q   Pu Wen-Hui WH   Li Ze-Yang ZY   Wei Xiao-Cheng XC   Wang Wen W   Cui Guang-Bin GB  

BMC medical imaging 20210203 1


<h4>Background</h4>Based on conventional MRI images, it is difficult to differentiatepseudoprogression from true progressionin GBM patients after standard treatment, which isa critical issue associated with survival. The aim of this study was to evaluate the diagnostic performance of machine learning using radiomics modelfrom T<sub>1</sub>-weighted contrast enhanced imaging(T<sub>1</sub>CE) in differentiating pseudoprogression from true progression after standard treatment for GBM.<h4>Methods</h  ...[more]

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