Skip to main content
Erschienen in: European Radiology 10/2019

07.03.2019 | Neuro

A radiomics nomogram based on multiparametric MRI might stratify glioblastoma patients according to survival

verfasst von: Xi Zhang, Hongbing Lu, Qiang Tian, Na Feng, Lulu Yin, Xiaopan Xu, Peng Du, Yang Liu

Erschienen in: European Radiology | Ausgabe 10/2019

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To construct a radiomics nomogram for the individualized estimation of the survival stratification in glioblastoma (GBM) patients using the multiregional information extracted from multiparametric MRI, which could facilitate the clinical decision-making for GBM patients.

Materials and methods

A total of 105 eligible GBM patients (57 in the long-term and 48 in the short-term survival groups, separated by an overall survival of 12 months) were selected from the Cancer Genome Atlas. These patients were divided into a training set (n = 70) and a validation set (n = 35). Radiomics features (n = 4000) were extracted from multiple regions of the GBM using multiparametric MRI. Then, a radiomics signature was constructed using least absolute shrinkage and selection operator regression for each patient in the training set. Combined with clinical risk factors, a radiomics nomogram was constructed based on a multivariate logistic regression model. The performance of this radiomics nomogram was assessed by calibration, discrimination, and clinical usefulness.

Results

The radiomics signature consisted of 25 selected features and performed better than clinical risk factors (i.e., age, Karnofsky performance status, and treatment strategy) in survival stratification. When the radiomics signature and clinical risk factors were combined, the radiomics nomogram exhibited promising discrimination in the training (C-index, 0.971) and validation (C-index, 0.974) sets. The favorable calibration and decision curve analysis indicated the clinical usefulness of the radiomics nomogram.

Conclusions

The presented radiomics nomogram, as a non-invasive prediction tool, could exhibit a favorable predictive accuracy and provide individualized probabilities of survival stratification for GBM patients.

Key Points

• Non-invasive survival stratification of GBM patients can be obtained with a radiomics nomogram.
• The proposed nomogram constructed by radiomics signature selected from 4000 radiomics features, combined with independent clinical risk factors such as age, Karnofsky performance status, and treatment strategy.
• The proposed radiomics nomogram exhibited good calibration and discrimination for survival stratification of GBM patients in both training (C-index, 0.971) and validation (C-index, 0.974) sets.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Ostrom QT, Gittleman H, Stetson L, Virk SM, Barnholtz-Sloan JS (2015) Epidemiology of gliomas. Cancer Treat Res 163:1–14CrossRefPubMed Ostrom QT, Gittleman H, Stetson L, Virk SM, Barnholtz-Sloan JS (2015) Epidemiology of gliomas. Cancer Treat Res 163:1–14CrossRefPubMed
2.
Zurück zum Zitat Van Meir EG, Hadjipanayis CG, Norden AD, Shu HK, Wen PY, Olson JJ (2010) Exciting new advances in neuro-oncology: the avenue to a cure for malignant glioma. CA Cancer J Clin 60:166–193CrossRefPubMedPubMedCentral Van Meir EG, Hadjipanayis CG, Norden AD, Shu HK, Wen PY, Olson JJ (2010) Exciting new advances in neuro-oncology: the avenue to a cure for malignant glioma. CA Cancer J Clin 60:166–193CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Smoll NR, Schaller K, Gautschi OP (2013) Long-term survival of patients with glioblastoma multiforme (GBM). J Clin Neurosci 20:670–675CrossRefPubMed Smoll NR, Schaller K, Gautschi OP (2013) Long-term survival of patients with glioblastoma multiforme (GBM). J Clin Neurosci 20:670–675CrossRefPubMed
4.
Zurück zum Zitat Sottoriva A, Spiteri I, Piccirillo SG et al (2013) Intratumor heterogeneity in human glioblastoma reflects cancer evolutionary dynamics. Proc Natl Acad Sci U S A 110:4009–4014CrossRefPubMedPubMedCentral Sottoriva A, Spiteri I, Piccirillo SG et al (2013) Intratumor heterogeneity in human glioblastoma reflects cancer evolutionary dynamics. Proc Natl Acad Sci U S A 110:4009–4014CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Prasanna P, Patel J, Partovi S, Madabhushi A, Tiwari P (2017) Radiomic features from the peritumoral brain parenchyma on treatment-naive multi-parametric MR imaging predict long versus short-term survival in glioblastoma multiforme: preliminary findings. Eur Radiol 27:4188–4197CrossRefPubMed Prasanna P, Patel J, Partovi S, Madabhushi A, Tiwari P (2017) Radiomic features from the peritumoral brain parenchyma on treatment-naive multi-parametric MR imaging predict long versus short-term survival in glioblastoma multiforme: preliminary findings. Eur Radiol 27:4188–4197CrossRefPubMed
6.
Zurück zum Zitat Zhou M, Scott J, Chaudhury B et al (2018) Radiomics in brain tumor: image assessment, quantitative feature descriptors, and machine-learning approaches. AJNR Am J Neuroradiol 39:208–216CrossRefPubMedPubMedCentral Zhou M, Scott J, Chaudhury B et al (2018) Radiomics in brain tumor: image assessment, quantitative feature descriptors, and machine-learning approaches. AJNR Am J Neuroradiol 39:208–216CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Laws ER, Parney IF, Huang W et al (2003) Survival following surgery and prognostic factors for recently diagnosed malignant glioma: data from the glioma outcomes project. J Neurosurg 99:467–473CrossRefPubMed Laws ER, Parney IF, Huang W et al (2003) Survival following surgery and prognostic factors for recently diagnosed malignant glioma: data from the glioma outcomes project. J Neurosurg 99:467–473CrossRefPubMed
8.
Zurück zum Zitat Gately L, McLachlan SA, Philip J, Ruben J, Dowling A (2018) Long-term survivors of glioblastoma: a closer look. J Neurooncol 136:155–162CrossRefPubMed Gately L, McLachlan SA, Philip J, Ruben J, Dowling A (2018) Long-term survivors of glioblastoma: a closer look. J Neurooncol 136:155–162CrossRefPubMed
9.
Zurück zum Zitat Kickingereder P, Burth S, Wick A et al (2016) Radiomic profiling of glioblastoma: identifying an imaging predictor of patient survival with improved performance over established clinical and radiologic risk models. Radiology 280:880–889CrossRefPubMed Kickingereder P, Burth S, Wick A et al (2016) Radiomic profiling of glioblastoma: identifying an imaging predictor of patient survival with improved performance over established clinical and radiologic risk models. Radiology 280:880–889CrossRefPubMed
11.
Zurück zum Zitat Fouke SJ, Benzinger T, Gibson D, Ryken TC, Kalkanis SN, Olson JJ (2015) The role of imaging in the management of adults with diffuse low grade glioma: a systematic review and evidence-based clinical practice guideline. J Neurooncol 125:457–479CrossRefPubMed Fouke SJ, Benzinger T, Gibson D, Ryken TC, Kalkanis SN, Olson JJ (2015) The role of imaging in the management of adults with diffuse low grade glioma: a systematic review and evidence-based clinical practice guideline. J Neurooncol 125:457–479CrossRefPubMed
12.
Zurück zum Zitat Aerts HJ (2016) The potential of radiomic-based phenotyping in precision medicine: a review. JAMA Oncol 2:1636–1642CrossRefPubMed Aerts HJ (2016) The potential of radiomic-based phenotyping in precision medicine: a review. JAMA Oncol 2:1636–1642CrossRefPubMed
13.
Zurück zum Zitat Gutman DA, Cooper LA, Hwang SN et al (2013) MR imaging predictors of molecular profile and survival: multi-institutional study of the TCGA glioblastoma data set. Radiology 267:560–569CrossRefPubMedPubMedCentral Gutman DA, Cooper LA, Hwang SN et al (2013) MR imaging predictors of molecular profile and survival: multi-institutional study of the TCGA glioblastoma data set. Radiology 267:560–569CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Jain R, Poisson LM, Gutman D et al (2014) Outcome prediction in patients with glioblastoma by using imaging, clinical, and genomic biomarkers: focus on the nonenhancing component of the tumor. Radiology 272:484–493CrossRefPubMed Jain R, Poisson LM, Gutman D et al (2014) Outcome prediction in patients with glioblastoma by using imaging, clinical, and genomic biomarkers: focus on the nonenhancing component of the tumor. Radiology 272:484–493CrossRefPubMed
15.
Zurück zum Zitat Itakura H, Achrol AS, Mitchell LA et al (2015) Magnetic resonance image features identify glioblastoma phenotypic subtypes with distinct molecular pathway activities. Sci Transl Med 7:303ra138CrossRefPubMedPubMedCentral Itakura H, Achrol AS, Mitchell LA et al (2015) Magnetic resonance image features identify glioblastoma phenotypic subtypes with distinct molecular pathway activities. Sci Transl Med 7:303ra138CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Shukla G, Alexander GS, Bakas S et al (2017) Advanced magnetic resonance imaging in glioblastoma: a review. Chin Clin Oncol 6:40CrossRefPubMed Shukla G, Alexander GS, Bakas S et al (2017) Advanced magnetic resonance imaging in glioblastoma: a review. Chin Clin Oncol 6:40CrossRefPubMed
17.
Zurück zum Zitat Wu CX, Lin GS, Lin ZX et al (2015) Peritumoral edema on magnetic resonance imaging predicts a poor clinical outcome in malignant glioma. Oncol Lett 10:2769–2776CrossRefPubMedPubMedCentral Wu CX, Lin GS, Lin ZX et al (2015) Peritumoral edema on magnetic resonance imaging predicts a poor clinical outcome in malignant glioma. Oncol Lett 10:2769–2776CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Limkin EJ, Sun R, Dercle L et al (2017) Promises and challenges for the implementation of computational medical imaging (radiomics) in oncology. Ann Oncol 28:1191–1206CrossRefPubMed Limkin EJ, Sun R, Dercle L et al (2017) Promises and challenges for the implementation of computational medical imaging (radiomics) in oncology. Ann Oncol 28:1191–1206CrossRefPubMed
19.
Zurück zum Zitat Lambin P, Leijenaar RTH, Deist TM et al (2017) Radiomics: the bridge between medical imaging and personalized medicine. Nat Rev Clin Oncol 14:749–762CrossRefPubMed Lambin P, Leijenaar RTH, Deist TM et al (2017) Radiomics: the bridge between medical imaging and personalized medicine. Nat Rev Clin Oncol 14:749–762CrossRefPubMed
20.
Zurück zum Zitat Gittleman H, Lim D, Kattan MW et al (2017) An independently validated nomogram for individualized estimation of survival among patients with newly diagnosed glioblastoma: NRG Oncology RTOG 0525 and 0825. Neuro Oncol 19:669–677CrossRefPubMed Gittleman H, Lim D, Kattan MW et al (2017) An independently validated nomogram for individualized estimation of survival among patients with newly diagnosed glioblastoma: NRG Oncology RTOG 0525 and 0825. Neuro Oncol 19:669–677CrossRefPubMed
21.
Zurück zum Zitat Gold JS, Gönen M, Gutiérrez A et al (2009) Development and validation of a prognostic nomogram for recurrence-free survival after complete surgical resection of localised primary gastrointestinal stromal tumour: a retrospective analysis. Lancet Oncol 10:1045–1052CrossRefPubMedPubMedCentral Gold JS, Gönen M, Gutiérrez A et al (2009) Development and validation of a prognostic nomogram for recurrence-free survival after complete surgical resection of localised primary gastrointestinal stromal tumour: a retrospective analysis. Lancet Oncol 10:1045–1052CrossRefPubMedPubMedCentral
22.
23.
Zurück zum Zitat Huang YQ, Liang CH, He L et al (2016) Development and validation of a radiomics nomogram for preoperative prediction of lymph node metastasis in colorectal cancer. J Clin Oncol 34:2157–2164CrossRefPubMed Huang YQ, Liang CH, He L et al (2016) Development and validation of a radiomics nomogram for preoperative prediction of lymph node metastasis in colorectal cancer. J Clin Oncol 34:2157–2164CrossRefPubMed
24.
Zurück zum Zitat Zhang B, Tian J, Dong D et al (2017) Radiomics features of multiparametric MRI as novel prognostic factors in advanced nasopharyngeal carcinoma. Clin Cancer Res 23:4259–4269CrossRefPubMed Zhang B, Tian J, Dong D et al (2017) Radiomics features of multiparametric MRI as novel prognostic factors in advanced nasopharyngeal carcinoma. Clin Cancer Res 23:4259–4269CrossRefPubMed
25.
Zurück zum Zitat Wu S, Zheng J, Li Y et al (2017) A radiomics nomogram for the preoperative prediction of lymph node metastasis in bladder cancer. Clin Cancer Res 23:6904–6911CrossRefPubMed Wu S, Zheng J, Li Y et al (2017) A radiomics nomogram for the preoperative prediction of lymph node metastasis in bladder cancer. Clin Cancer Res 23:6904–6911CrossRefPubMed
27.
Zurück zum Zitat Clark K, Vendt B, Smith K et al (2013) The cancer imaging archive (TCIA): maintaining and operating a public information repository. J Digit Imaging 26:1045–1057CrossRefPubMedPubMedCentral Clark K, Vendt B, Smith K et al (2013) The cancer imaging archive (TCIA): maintaining and operating a public information repository. J Digit Imaging 26:1045–1057CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Collewet G, Strzelecki M, Mariette F (2004) Influence of MRI acquisition protocols and image intensity normalization methods on texture classification. Magn Reson Imaging 22:81–91CrossRefPubMed Collewet G, Strzelecki M, Mariette F (2004) Influence of MRI acquisition protocols and image intensity normalization methods on texture classification. Magn Reson Imaging 22:81–91CrossRefPubMed
29.
Zurück zum Zitat Tibshirani R (2011) Regression shrinkage and selection via the Lasso. J R Stat Soc Series B Stat Methodol 73:273–282CrossRef Tibshirani R (2011) Regression shrinkage and selection via the Lasso. J R Stat Soc Series B Stat Methodol 73:273–282CrossRef
30.
Zurück zum Zitat Iasonos A, Schrag D, Raj GV, Panageas KS (2008) How to build and interpret a nomogram for cancer prognosis. J Clin Oncol 26:1364–1370CrossRefPubMed Iasonos A, Schrag D, Raj GV, Panageas KS (2008) How to build and interpret a nomogram for cancer prognosis. J Clin Oncol 26:1364–1370CrossRefPubMed
33.
Zurück zum Zitat Cheng W, Zhang C, Ren X et al (2017) Treatment strategy and IDH status improve nomogram validity in newly diagnosed GBM patients. Neuro Oncol 19:736–738CrossRefPubMedPubMedCentral Cheng W, Zhang C, Ren X et al (2017) Treatment strategy and IDH status improve nomogram validity in newly diagnosed GBM patients. Neuro Oncol 19:736–738CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Gorlia T, van den Bent MJ, Hegi ME et al (2008) Nomograms for predicting survival of patients with newly diagnosed glioblastoma: prognostic factor analysis of EORTC and NCIC trial 26981-22981/CE.3. Lancet Oncol 9:29–38CrossRefPubMed Gorlia T, van den Bent MJ, Hegi ME et al (2008) Nomograms for predicting survival of patients with newly diagnosed glioblastoma: prognostic factor analysis of EORTC and NCIC trial 26981-22981/CE.3. Lancet Oncol 9:29–38CrossRefPubMed
35.
Zurück zum Zitat Chaddad A, Sabri S, Niazi T, Abdulkarim B (2018) Prediction of survival with multi-scale radiomic analysis in glioblastoma patients. Med Biol Eng Comput 56:2287–2300 Chaddad A, Sabri S, Niazi T, Abdulkarim B (2018) Prediction of survival with multi-scale radiomic analysis in glioblastoma patients. Med Biol Eng Comput 56:2287–2300
36.
Zurück zum Zitat Boxerman JL, Zhang Z, Safriel Y et al (2018) Prognostic value of contrast enhancement and FLAIR for survival in newly diagnosed glioblastoma treated with and without bevacizumab: results from ACRIN 6686. Neuro Oncol 20:1400–1410 Boxerman JL, Zhang Z, Safriel Y et al (2018) Prognostic value of contrast enhancement and FLAIR for survival in newly diagnosed glioblastoma treated with and without bevacizumab: results from ACRIN 6686. Neuro Oncol 20:1400–1410
37.
Zurück zum Zitat Wang K, Wang Y, Fan X et al (2016) Radiological features combined with IDH1 status for predicting the survival outcome of glioblastoma patients. Neuro Oncol 18:589–597CrossRefPubMed Wang K, Wang Y, Fan X et al (2016) Radiological features combined with IDH1 status for predicting the survival outcome of glioblastoma patients. Neuro Oncol 18:589–597CrossRefPubMed
38.
Zurück zum Zitat Brynolfsson P, Nilsson D, Henriksson R et al (2014) ADC texture--an imaging biomarker for high-grade glioma? Med Phys 41:101903CrossRefPubMed Brynolfsson P, Nilsson D, Henriksson R et al (2014) ADC texture--an imaging biomarker for high-grade glioma? Med Phys 41:101903CrossRefPubMed
39.
Zurück zum Zitat Chaddad A, Tanougast C (2016) Extracted magnetic resonance texture features discriminate between phenotypes and are associated with overall survival in glioblastoma multiforme patients. Med Biol Eng Comput 54:1707–1718 Chaddad A, Tanougast C (2016) Extracted magnetic resonance texture features discriminate between phenotypes and are associated with overall survival in glioblastoma multiforme patients. Med Biol Eng Comput 54:1707–1718
40.
Zurück zum Zitat Liu S, Wang Y, Xu K et al (2017) Relationship between necrotic patterns in glioblastoma and patient survival: fractal dimension and lacunarity analyses using magnetic resonance imaging. Sci Rep 7:8302CrossRefPubMedPubMedCentral Liu S, Wang Y, Xu K et al (2017) Relationship between necrotic patterns in glioblastoma and patient survival: fractal dimension and lacunarity analyses using magnetic resonance imaging. Sci Rep 7:8302CrossRefPubMedPubMedCentral
41.
Zurück zum Zitat Ellingson BM, Harris RJ, Woodworth DC et al (2017) Baseline pretreatment contrast enhancing tumor volume including central necrosis is a prognostic factor in recurrent glioblastoma: evidence from single and multicenter trials. Neuro Oncol 19:89–98CrossRefPubMed Ellingson BM, Harris RJ, Woodworth DC et al (2017) Baseline pretreatment contrast enhancing tumor volume including central necrosis is a prognostic factor in recurrent glioblastoma: evidence from single and multicenter trials. Neuro Oncol 19:89–98CrossRefPubMed
42.
Zurück zum Zitat Bakas S, Akbari H, Sotiras A et al (2017) Advancing the cancer genome atlas glioma MRI collections with expert segmentation labels and radiomic features. Sci Data 4:170117CrossRefPubMedPubMedCentral Bakas S, Akbari H, Sotiras A et al (2017) Advancing the cancer genome atlas glioma MRI collections with expert segmentation labels and radiomic features. Sci Data 4:170117CrossRefPubMedPubMedCentral
43.
Zurück zum Zitat Hainc N, Stippich C, Stieltjes B, Leu S, Bink A (2017) Experimental texture analysis in glioblastoma: a methodological study. Invest Radiol 52:367–373CrossRefPubMed Hainc N, Stippich C, Stieltjes B, Leu S, Bink A (2017) Experimental texture analysis in glioblastoma: a methodological study. Invest Radiol 52:367–373CrossRefPubMed
Metadaten
Titel
A radiomics nomogram based on multiparametric MRI might stratify glioblastoma patients according to survival
verfasst von
Xi Zhang
Hongbing Lu
Qiang Tian
Na Feng
Lulu Yin
Xiaopan Xu
Peng Du
Yang Liu
Publikationsdatum
07.03.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 10/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06069-z

Weitere Artikel der Ausgabe 10/2019

European Radiology 10/2019 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.