Radiomics in peritumoral non-enhancing regions: fractional anisotropy and cerebral blood volume improve prediction of local progression and overall survival in patients with glioblastoma.
PURPOSE
The peritumoral non-enhancing region (NER) is frequently not removed during the surgical resection of glioblastoma, with most recurrences occurring within the original treatment field. This study determined whether radiomics analysis of the NER can predict local recurrence and overall survival in patients with glioblastoma.


METHODS
Preoperative magnetic resonance imaging (MRI) scans from 83 consecutive patients with glioblastoma were retrospectively reviewed and grouped into training (n = 59) and test sets (n = 24). A total of 6472 radiomic features were extracted from contrast-enhanced T1-weighted and fluid-attenuated inversion recovery images and from fractional anisotropy (FA) and normalized cerebral blood volume (CBV) maps. A diagnostic model to predict 6-month progression was tested using the area under the receiver operating characteristics curve (AUC) and compared with the single parameters of FA and CBV. A survival model was tested using Harrell's C-index and compared with clinical models that included age, sex, Karnofsky performance score, and extent of surgical resection.


RESULTS
Four FA features and six CBV features were selected for the diagnostic model; no features were extracted from conventional MRI. Combined FA and CBV radiomics showed better predictive value for local progression (AUC, 0.79; 95% CI, 0.67-0.90) than single imaging radiomics (AUC, 0.70-0.76) or single imaging parameters (AUC, 0.51-0.54). The combined model (C-index, 0.87) improved prognostication when added to clinical models (C-index, 0.72).


CONCLUSION
Radiomics features using FA and CBV in the NER have the potential to improve prediction of local progression and overall survival in patients with glioblastoma.
['Kim|Jung Youn|JY|', 'Yoon|Min Jae|MJ|', 'Park|Ji Eun|JE|http://orcid.org/0000-0002-4419-4682', 'Choi|Eun Jung|EJ|', 'Lee|Jongho|J|', 'Kim|Ho Sung|HS|']
D016880:Anisotropy D001932:Brain Neoplasms D000071937:Cerebral Blood Volume D003287:Contrast Media D018450:Disease Progression D005260:Female D005909:Glioblastoma D006801:Humans D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D011237:Predictive Value of Tests D015996:Survival Rate
Anisotropy Glioblastoma Disease progression Perfusion imaging Survival analysis