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European Radiology
Published in: European Radiology 8/2022

12-03-2022 | Glioblastoma | Imaging Informatics and Artificial Intelligence

Glioma survival prediction from whole-brain MRI without tumor segmentation using deep attention network: a multicenter study

Authors: Zhi-Cheng Li, Jing Yan, Shenghai Zhang, Chaofeng Liang, Xiaofei Lv, Yan Zou, Huailing Zhang, Dong Liang, Zhenyu Zhang, Yinsheng Chen

Published in: European Radiology | Issue 8/2022

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Abstract

Objectives

To develop and validate a deep learning model for predicting overall survival from whole-brain MRI without tumor segmentation in patients with diffuse gliomas.

Methods

In this multicenter retrospective study, two deep learning models were built for survival prediction from MRI, including a DeepRisk model built from whole-brain MRI, and an original ResNet model built from expert-segmented tumor images. Both models were developed using a training dataset (n = 935) and an internal tuning dataset (n = 156) and tested on two external test datasets (n = 194 and 150) and a TCIA dataset (n = 121). C-index, integrated Brier score (IBS), prediction error curves, and calibration curves were used to assess the model performance.

Results

In total, 1556 patients were enrolled (age, 49.0 ± 13.1 years; 830 male). The DeepRisk score was an independent predictor and can stratify patients in each test dataset into three risk subgroups. The IBS and C-index for DeepRisk were 0.14 and 0.83 in external test dataset 1, 0.15 and 0.80 in external dataset 2, and 0.16 and 0.77 in TCIA dataset, respectively, which were comparable with those for original ResNet. The AUCs at 6, 12, 24, 26, and 48 months for DeepRisk ranged between 0.77 and 0.94. Combining DeepRisk score with clinicomolecular factors resulted in a nomogram with a better calibration and classification accuracy (net reclassification improvement 0.69, p < 0.001) than the clinical nomogram.

Conclusions

DeepRisk that obviated the need of tumor segmentation can predict glioma survival from whole-brain MRI and offers incremental prognostic value.

Key Points

• DeepRisk can predict overall survival directly from whole-brain MRI without tumor segmentation.
• DeepRisk achieves comparable accuracy in survival prediction with deep learning model built using expert-segmented tumor images.
• DeepRisk has independent and incremental prognostic value over existing clinical parameters and IDH mutation status.
Appendix
Available only for authorised users
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Metadata
Title
Glioma survival prediction from whole-brain MRI without tumor segmentation using deep attention network: a multicenter study
Authors
Zhi-Cheng Li
Jing Yan
Shenghai Zhang
Chaofeng Liang
Xiaofei Lv
Yan Zou
Huailing Zhang
Dong Liang
Zhenyu Zhang
Yinsheng Chen
Publication date
12-03-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-022-08640-7

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