RT Journal Article
SR Electronic
T1 MRI Features May Predict Molecular Features of Glioblastoma in <em>Isocitrate Dehydrogenase</em> Wild-Type Lower-Grade Gliomas
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A6983
A1 C.J. Park
A1 K. Han
A1 H. Kim
A1 S.S. Ahn
A1 D. Choi
A1 Y.W. Park
A1 J.H. Chang
A1 S.H. Kim
A1 S. Cha
A1 S.-K. Lee
YR 2021
UL http://www.ajnr.org/content/early/2021/01/28/ajnr.A6983.abstract
AB BACKGROUND AND PURPOSE: Isocitrate dehydrogenase (IDH) wild-type lower-grade gliomas (histologic grades II and III) with epidermal growth factor receptor (EGFR) amplification or telomerase reverse transcriptase (TERT) promoter mutation are reported to behave similar to glioblastoma. We aimed to evaluate whether MR imaging features could identify a subset of IDH wild-type lower-grade gliomas that carry molecular features of glioblastoma.MATERIALS AND METHODS: In this multi-institutional retrospective study, pathologically confirmed IDH wild-type lower-grade gliomas from 2 tertiary institutions and The Cancer Genome Atlas constituted the training set (institution 1 and The Cancer Genome Atlas, 64 patients) and the independent test set (institution 2, 57 patients). Preoperative MRIs were analyzed using the Visually AcceSAble Rembrandt Images and radiomics. The molecular glioblastoma status was determined on the basis of the presence of EGFR amplification and TERT promoter mutation. Molecular glioblastoma was present in 73.4% and 56.1% in the training and test sets, respectively. Models using clinical, Visually AcceSAble Rembrandt Images, and radiomic features were built to predict the molecular glioblastoma status in the training set; then they were validated in the test set.RESULTS: In the test set, a model using both Visually AcceSAble Rembrandt Images and radiomic features showed superior predictive performance (area under the curve = 0.854) than that with only clinical features or Visually AcceSAble Rembrandt Images (areas under the curve = 0.514 and 0.648, respectively; P &lt; . 001, both). When both Visually AcceSAble Rembrandt Images and radiomics were added to clinical features, the predictive performance significantly increased (areas under the curve = 0.514 versus 0.863, P &lt; .001).CONCLUSIONS: MR imaging features integrated with machine learning classifiers may predict a subset of IDH wild-type lower-grade gliomas that carry molecular features of glioblastoma.AUCarea under the receiver operating characteristic curvecIMPACT-NOWConsortium to Inform Molecular and Practical Approaches to CNS Tumor TaxonomyGBMglioblastomaLASSOleast absolute shrinkage and selection operatorRFErecursive feature eliminationSVMsupport vector machineTCGAThe Cancer Genome AtlasVASARIVisually AcceSAble Rembrandt ImagesWHOWorld Health Organization