Clinical applications of quantitative three-dimensional MRI analysis for pediatric embryonal brain tumors

Publication date: Available online 8 June 2018
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Jared H. Hara, Ashley Wu, Javier E. Villanueva-Meyer, Gilmer Valdes, Vikas Daggubati, Sabine Mueller, Timothy D. Solberg, Steve E. Braunstein, Olivier Morin, David R. Raleigh
ObjectivesTo investigate the prognostic utility of quantitative three-dimensional (3D) magnetic resonance imaging (MRI) radiomic analysis for primary pediatric embryonal brain tumorsMethodsThirty-four pediatric embryonal brain tumor patients with concurrent pre-operative T1-weighted post contrast (T1PG) and T2-weighted fluid-attenuated inversion recovery (FLAIR) MR images were identified from an institutional database. The median follow-up was 5.2 years. Radiomic features were extracted from axial T1PG and FLAIR contours using MATLAB, and 15 features were selected for analysis based on qualitative radiographic features with prognostic significance for pediatric embryonal brain tumors. Logistic regression, linear regression, receiver operating characteristic curve, Harrell's C index and Somer's D index were used to test the relationships between radiomic features, demographic variables and clinical outcomes.ResultsWe found that pediatric embryonal brain tumors in older patients had increased normalized mean tumor intensity (P=0.05, T1PG), decreased tumor volume (P=0.02, T1PG) and increased markers of heterogeneity (P≤0.01, T1PG and FLAIR) relative to younger patients. We identified 10 quantitative radiomic features that delineated between medulloblastoma, pineoblastoma and supratentorial primitive neuroectodermal tumor, including size and heterogeneity (P≤0.05, T1PG and FLAIR). Decreased markers of tumor heterogeneity were predictive of neuraxis metastases and trended towards significance (P=0.1, FLAIR). Tumors with increased size (AUC=0.7, FLAIR) and decreased heterogeneity (AUC=0.7, FLAIR) at diagnosis were more likely to recur.ConclusionsQuantitative radiomic features are associated with pediatric embryonal brain tumor patient age, histology, neuraxis metastases and recurrence. These data suggest that quantitative 3D MRI radiomic analysis has the non-invasive potential to identify radiomic risk features for pediatric embryonal brain tumor patients.

Teaser

The relationship between clinical outcomes and imaging characteristics of pediatric embryonal brain tumors is poorly understood. Here, we analyze embryonal brain tumor magnetic resonance images to identify quantitative radiomic features associated with clinical outcomes. Our results demonstrate that features quantifying primary tumor size and heterogeneity are associated with patient age, neuraxis metastases, histology and recurrence. These data suggest that 3D MRI analysis has the non-invasive potential to identify radiomic risk features for pediatric embryonal brain tumor patients.


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