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      The feasibility of MRI texture analysis in distinguishing glioblastoma, anaplastic astrocytoma and anaplastic oligodendroglioma

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          Abstract

          Background

          The aim of this study was to investigate whether texture analysis-based machine learning could be utilized in presurgical differentiation of high-grade gliomas in adults.

          Methods

          This is a single-center retrospective study involving 150 patients diagnosed with glioblastoma (GBM) (n=50), anaplastic astrocytoma (AA) (n=50) or anaplastic oligodendroglioma (AO) (n=50). The training group and validation group were randomly divided with a 4:1 ratio. Forty texture features were extracted from contrast-enhanced T1-weighted images using LIFEx software. Two feature-selection methods were separately introduced to select optimal features, including distance correlation (DC) and least absolute shrinkage and selection operator (LASSO). Optimal features selected were fed into linear discriminant analysis (LDA) classifier and support vector machine (SVM) classifier to establish multiple classification models. The performance was evaluated by using the accuracy, Kappa value and area under receiver operating characteristic curve (AUC) of each model.

          Results

          The overall diagnostic accuracies of LDA-based models were 76.0% (DC + LDA) and 74.3% (LASSO + LDA) in the validation group, while for SVM-based models were 58.0% (DC + SVM) and 63.3% (LASSO + SVM). The combination of DC and LDA reach the highest diagnostic accuracy, AUC of GBM, AA and AO were 0.999, 0.834 and 0.865 separately, indicating that this model could distinguish GBM from AA and AO commendably, whereas the differentiation between AA and AO was relatively difficult.

          Conclusions

          This study indicated that MRI texture analysis combined with LDA algorithm has the potential to be utilized in distinguishing the subtypes of high-grade gliomas.

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          Most cited references55

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          European Association for Neuro-Oncology (EANO) guideline on the diagnosis and treatment of adult astrocytic and oligodendroglial gliomas.

          The European Association for Neuro-Oncology guideline provides recommendations for the clinical care of adult patients with astrocytic and oligodendroglial gliomas, including glioblastomas. The guideline is based on the 2016 WHO classification of tumours of the central nervous system and on scientific developments since the 2014 guideline. The recommendations focus on pathological and radiological diagnostics, and the main treatment modalities of surgery, radiotherapy, and pharmacotherapy. In this guideline we have also integrated the results from contemporary clinical trials that have changed clinical practice. The guideline aims to provide guidance for diagnostic and management decisions, while limiting unnecessary treatments and costs. The recommendations are a resource for professionals involved in the management of patients with glioma, for patients and caregivers, and for health-care providers in Europe. The implementation of this guideline requires multidisciplinary structures of care, and defined processes of diagnosis and treatment.
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            LIFEx: A Freeware for Radiomic Feature Calculation in Multimodality Imaging to Accelerate Advances in the Characterization of Tumor Heterogeneity

            Textural and shape analysis is gaining considerable interest in medical imaging, particularly to identify parameters characterizing tumor heterogeneity and to feed radiomic models. Here, we present a free, multiplatform, and easy-to-use freeware called LIFEx, which enables the calculation of conventional, histogram-based, textural, and shape features from PET, SPECT, MR, CT, and US images, or from any combination of imaging modalities. The application does not require any programming skills and was developed for medical imaging professionals. The goal is that independent and multicenter evidence of the usefulness and limitations of radiomic features for characterization of tumor heterogeneity and subsequent patient management can be gathered. Many options are offered for interactive textural index calculation and for increasing the reproducibility among centers. The software already benefits from a large user community (more than 800 registered users), and interactions within that community are part of the development strategy.Significance: This study presents a user-friendly, multi-platform freeware to extract radiomic features from PET, SPECT, MR, CT, and US images, or any combination of imaging modalities. Cancer Res; 78(16); 4786-9. ©2018 AACR.
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              Advances in the molecular genetics of gliomas — implications for classification and therapy

              In 2016, a revised WHO classification of glioma was published, in which molecular data and traditional histological information are incorporated into integrated diagnoses. Herein, the authors highlight the developments in our understanding of the molecular genetics of gliomas that underlie this classification, and review the current landscape of molecular biomarkers used in the classification of disease subtypes. In addition, they discuss how these advances can promote the development of novel pathogenesis-based therapeutic approaches, paving the way to precision medicine.
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                Author and article information

                Journal
                Transl Cancer Res
                Transl Cancer Res
                TCR
                Translational Cancer Research
                AME Publishing Company
                2218-676X
                2219-6803
                November 2022
                November 2022
                : 11
                : 11
                : 4079-4088
                Affiliations
                [1 ]deptDepartment of Neurosurgery, West China Hospital , Sichuan University , Chengdu, China;
                [2 ]deptWest China School of Medicine, West China Hospital , Sichuan University , Chengdu, China
                Author notes

                Contributions: (I) Conception and design: Y Teng, J Xu; (II) Administrative support: J Xu; (III) Provision of study materials or patients: Y Teng, C Chen; (IV) Collection and assembly of data: Y Teng, C Chen, Y Zhang; (V) Data analysis and interpretation: Y Teng; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

                Correspondence to: Jianguo Xu. Department of Neurosurgery, West China Hosptial, No. 37, Guoxue Alley, Chengdu 610041, China. Email: drjianguoxu@ 123456gmail.com .
                Article
                tcr-11-11-4079
                10.21037/tcr-22-1390
                9745368
                36523299
                bf936474-6260-4dea-9be8-9121f6036c69
                2022 Translational Cancer Research. All rights reserved.

                Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0.

                History
                : 17 May 2022
                : 12 September 2022
                Funding
                Funded by: 1·3·5 project for disciplines of excellence—Clinical Research Incubation Project, West China Hospital, Sichuan University
                Award ID: No. 2020HXFH036
                Categories
                Original Article

                glioblastoma (gbm),anaplastic astrocytoma (aa),anaplastic oligodendroglioma (ao),machine learning,differential diagnosis

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