Nocera Gianluca, Sanvito Francesco, Yao Jingwen, Oshima Sonoko, Bobholz Samuel A, Teraishi Ashley, Raymond Catalina, Patel Kunal, Everson Richard G, Liau Linda M, Connelly Jennifer, Castellano Antonella, Mortini Pietro, Salamon Noriko, Cloughesy Timothy F, LaViolette Peter S, Ellingson Benjamin M
UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California Los Angeles, Los Angeles, CA, USA.
Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
J Neurooncol. 2025 Jun 21. doi: 10.1007/s11060-025-05105-x.
PURPOSE: In brain gliomas, non-invasive biomarkers reflecting tumor cellularity would be useful to guide supramarginal resections and to plan stereotactic biopsies. We aim to validate a previously-trained machine learning algorithm that generates cellularity prediction maps (CPM) from multiparametric MRI data to an independent, retrospective external cohort of gliomas undergoing image-guided biopsies, and to compare the performance of CPM and diffusion MRI apparent diffusion coefficient (ADC) in predicting cellularity. METHODS: A cohort of patients with treatment-naïve or recurrent gliomas were prospectively studied. All patients underwent pre-surgical MRI according to the standardized brain tumor imaging protocol. The surgical sampling site was planned based on image-guided biopsy targets and tissue was stained with hematoxylin-eosin for cell density count. The correlation between MRI-derived CPM values and histological cellularity, and between ADC and histological cellularity, was evaluated both assuming independent observations and accounting for non-independent observations. RESULTS: Sixty-six samples from twenty-seven patients were collected. Thirteen patients had treatment-naïve tumors and fourteen had recurrent lesions. CPM value accurately predicted histological cellularity in treatment-naïve patients (b = 1.4, R = 0.2, p = 0.009, rho = 0.41, p = 0.016, RMSE = 1503 cell/mm), but not in the recurrent sub-cohort. Similarly, ADC values showed a significant association with histological cellularity only in treatment-naive patients (b = 1.3, R = 0.22, p = 0.007; rho = -0.37, p = 0.03), not statistically different from the CPM correlation. These findings were confirmed with statistical tests accounting for non-independent observations. CONCLUSION: MRI-derived machine learning generated cellularity prediction maps (CPM) enabled a non-invasive evaluation of tumor cellularity in treatment-naïve glioma patients, although CPM did not clearly outperform ADC alone in this cohort.
目的:在脑胶质瘤中,反映肿瘤细胞密度的非侵入性生物标志物对于指导超边缘切除术和规划立体定向活检很有用。我们旨在验证一种先前训练的机器学习算法,该算法可从多参数MRI数据生成细胞密度预测图(CPM),应用于接受图像引导活检的独立回顾性外部胶质瘤队列,并比较CPM和扩散MRI表观扩散系数(ADC)在预测细胞密度方面的性能。 方法:对一组未经治疗或复发性胶质瘤患者进行前瞻性研究。所有患者均按照标准化脑肿瘤成像方案进行术前MRI检查。根据图像引导活检靶点规划手术取样部位,组织用苏木精-伊红染色以进行细胞密度计数。在假设独立观察和考虑非独立观察的情况下,评估MRI衍生的CPM值与组织学细胞密度之间以及ADC与组织学细胞密度之间的相关性。 结果:收集了来自27名患者的66个样本。13名患者患有未经治疗的肿瘤,14名患者有复发病变。CPM值准确预测了未经治疗患者的组织学细胞密度(b = 1.4,R = 0.2,p = 0.009,rho = 0.41,p = 0.016,RMSE = 1503个细胞/mm),但在复发亚组中未成功预测。同样,ADC值仅在未经治疗的患者中与组织学细胞密度显示出显著相关性(b = 1.3,R = 0.22,p = 0.007;rho = -0.37,p = 0.03),与CPM相关性无统计学差异。这些发现通过考虑非独立观察的统计检验得到证实。 结论:MRI衍生的机器学习生成的细胞密度预测图(CPM)能够对未经治疗的胶质瘤患者的肿瘤细胞密度进行非侵入性评估,尽管在该队列中CPM并没有明显优于单独的ADC。
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