Radiogenomics of lower-grade gliomas: a radiomic signature as a biological surrogate for survival prediction.

OBJECTIVE

We aimed to identify a radiomic signature to be used as a noninvasive biomarker of prognosis in patients with lower-grade gliomas (LGGs) and to reveal underlying biological processes through comprehensive radiogenomic investigation.

METHODS

We extracted 55 radiomic features from T2-weighted images of 233 patients with LGGs (training cohort: = 85; validation cohort: = 148). Univariate Cox regression and linear risk score formula were applied to generate a radiomic-based signature. Gene ontology analysis of highly expressed genes in the high-risk score group was conducted to establish a radiogenomic map. A nomogram was constructed for individualized survival prediction.

RESULTS

The six-feature radiomic signature stratified patients in the training cohort into low- or high-risk groups for overall survival ( = 0.0018). This result was successfully verified in the validation cohort ( = 0.0396). Radiogenomic analysis revealed that the prognostic radiomic signature was associated with hypoxia, angiogenesis, apoptosis, and cell proliferation. The nomogram resulted in high prognostic accuracy (C-index: 0.92, C-index: 0.70) and favorable calibration for individualized survival prediction in the training and validation cohorts.

CONCLUSIONS

Our results suggest a great potential for the use of radiomic signature as a biological surrogate in providing prognostic information for patients with LGGs.