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European Radiology
Published in: European Radiology 12/2022

28-06-2022 | Glioma | Neuro

Adding radiomics to the 2021 WHO updates may improve prognostic prediction for current IDH-wildtype histological lower-grade gliomas with known EGFR amplification and TERT promoter mutation status

Authors: Yae Won Park, Sooyon Kim, Chae Jung Park, Sung Soo Ahn, Kyunghwa Han, Seok-Gu Kang, Jong Hee Chang, Se Hoon Kim, Seung-Koo Lee

Published in: European Radiology | Issue 12/2022

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Abstract

Objectives

To assess whether radiomic features could improve the accuracy of survival predictions of IDH-wildtype (IDHwt) histological lower-grade gliomas (LGGs) over clinicopathological features.

Methods

Preoperative MRI data of 61 patients with IDHwt histological LGGs were included as the institutional training set. The test set consisted of 32 patients from The Cancer Genome Atlas. Radiomic features (n = 186) were extracted using conventional MRIs. The radiomics risk score (RRS) for overall survival (OS) was derived from the elastic net. Multivariable Cox regression analyses with clinicopathological features (including epidermal growth factor receptor [EGFR] amplification and telomerase reverse transcriptase promoter [TERTp] mutation status) and the RRS were performed. The integrated area under the receiver operating curves (iAUCs) from the models with and without the RRS were compared. The net reclassification index (NRI) for 1-year OS was also calculated. The prognostic value of the RRS was evaluated using the external validation set.

Results

The RRS independently predicted OS (hazard ratio = 48.08; p = 0.001). Compared with the clinicopathological model alone, adding the RRS had a better OS prediction performance (iAUCs 0.775 vs. 0.910), which was internally validated (iAUCs 0.726 vs. 0.884, 1-year OS NRI = 0.497), and a similar trend was found on external validation (iAUCs 0.683 vs. 0.705, 1-year OS NRI = 0.733). The prognostic significance of the RRS was confirmed in the external validation set (p = 0.001).

Conclusions

Integrating radiomics with clinicopathological features (including EGFR amplification and TERTp mutation status) can improve survival prediction in patients with IDHwt LGGs.

Key Points

• Radiomics risk score has the potential to improve survival prediction when added to clinicopathological features (iAUCs increased from 0.775 to 0.910).
• NRIs for 1-year OS showed that the radiomics risk score had incremental value over the clinicopathological model.
• The prognostic significance of the radiomics risk score was confirmed in the external validation set (p = 0.001).
Appendix
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Metadata
Title
Adding radiomics to the 2021 WHO updates may improve prognostic prediction for current IDH-wildtype histological lower-grade gliomas with known EGFR amplification and TERT promoter mutation status
Authors
Yae Won Park
Sooyon Kim
Chae Jung Park
Sung Soo Ahn
Kyunghwa Han
Seok-Gu Kang
Jong Hee Chang
Se Hoon Kim
Seung-Koo Lee
Publication date
28-06-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-022-08941-x

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