Liu Luyan, Zhang Han, Rekik Islem, Chen Xiaobo, Wang Qian, Shen Dinggang
Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Med Image Comput Comput Assist Interv. 2016 Oct;9901:26-34. doi: 10.1007/978-3-319-46723-8_4. Epub 2016 Oct 2.
High-grade glioma (HGG) is a lethal cancer, which is characterized by very poor prognosis. To help optimize treatment strategy, accurate preoperative prediction of HGG patient's outcome (i.e., survival time) is of great clinical value. However, there are huge individual variability of HGG, which produces a large variation in survival time, thus making prognostic prediction more challenging. Previous brain imaging-based outcome prediction studies relied only on the imaging intensity inside or slightly around the tumor, while ignoring any information that is located far away from the lesion (i.e., the "normal appearing" brain tissue). Notably, in addition to altering MR image intensity, we hypothesize that the HGG growth and its mass effect also change both structural (can be modeled by diffusion tensor imaging (DTI)) and functional brain connectivities (estimated by functional magnetic resonance imaging (rs-fMRI)). Therefore, integrating connectomics information in outcome prediction could improve prediction accuracy. To this end, we unprecedentedly devise a machine learning-based HGG prediction framework that can effectively extract valuable features from complex human brain connectome using network analysis tools, followed by a novel multi-stage feature selection strategy to single out good features while reducing feature redundancy. Ultimately, we use support vector machine (SVM) to classify HGG outcome as either (survival time ≤ 650 days) or (survival time >650 days). Our method achieved 75 % prediction accuracy. We also found that functional and structural networks provide complementary information for the outcome prediction, thus leading to increased prediction accuracy compared with the baseline method, which only uses the basic clinical information (63.2 %).
高级别胶质瘤(HGG)是一种致命性癌症,其特点是预后极差。为了帮助优化治疗策略,术前准确预测HGG患者的预后(即生存时间)具有重要的临床价值。然而,HGG存在巨大的个体差异,这导致生存时间有很大差异,从而使预后预测更具挑战性。以往基于脑成像的预后预测研究仅依赖于肿瘤内部或其周围小范围的成像强度,而忽略了远离病变部位(即“看似正常”的脑组织)的任何信息。值得注意的是,除了改变磁共振图像强度外,我们推测HGG的生长及其占位效应还会改变大脑的结构连接性(可通过扩散张量成像(DTI)建模)和功能连接性(通过功能磁共振成像(rs-fMRI)估计)。因此,在预后预测中整合连接组学信息可以提高预测准确性。为此,我们前所未有地设计了一个基于机器学习的HGG预测框架,该框架可以使用网络分析工具从复杂的人类脑连接组中有效提取有价值的特征,随后采用一种新颖的多阶段特征选择策略来挑选出良好特征,同时减少特征冗余。最终,我们使用支持向量机(SVM)将HGG预后分类为(生存时间≤650天)或(生存时间>650天)。我们的方法实现了75%的预测准确率。我们还发现功能和结构网络为预后预测提供了互补信息,因此与仅使用基本临床信息的基线方法(63.2%)相比,预测准确率有所提高。