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Simple Summary: A high Ki-67 index usually suggests accelerated and uncontrolled cell proliferation correlated with tumor growth and is a prognostic factor that is associated with an increased recurrent risk in meningioma patients. The aim of our study is to predict the Ki-67 proliferative index in meningioma patients using machine learning technology. With 371 cases collected from two centers, we systematically analyzed the relevance between clinical/radiological features and the Ki-67 index. Moreover, with radiomic features extracted from postcontrast images, we built three radiomic models and three clinical radiological–radiomic models to predict the Ki-67 status. The models showed good performance, with an AUC of 0.837 in the internal test and 0.700 in the external test. The results provide a quantitative method to facilitate clinical decision making for meningioma patients. Background/aim This study aimed to explore the value of radiological and radiomic features retrieved from magnetic resonance imaging in the prediction of a Ki-67 proliferative index in meningioma patients using a machine learning model. Methods This multicenter, retrospective study included 371 patients collected from two centers. The Ki-67 expression was classified into low-expressed and high-expressed groups with a threshold of 5%. Clinical features and radiological features were collected and analyzed by using univariate and multivariate statistical analyses. Radiomic features were extracted from contrast-enhanced images, followed by three independent feature selections. Six predictive models were constructed with different combinations of features by using linear discriminant analysis (LDA) classifier. Results The multivariate analysis suggested that the presence of intratumoral necrosis (p = 0.032) and maximum diameter (p < 0.001) were independently correlated with a high Ki-67 status. The predictive models showed good performance with AUC of 0.837, accuracy of 0.810, sensitivity of 0.857, and specificity of 0.771 in the internal test and with AUC of 0.700, accuracy of 0.557, sensitivity of 0.314, and specificity of 0.885 in the external test. Conclusion The results of this study suggest that the predictive model can efficiently predict the Ki-67 index of meningioma patients to facilitate the therapeutic management. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the diagnostic ability of radiomics-based machine learning in differentiating atypical low-grade astrocytoma (LGA) from anaplastic astrocytoma (AA). Methods: The current study involved 175 patients diagnosed with LGA (n = 95) or AA (n = 80) and treated in the Neurosurgery Department of West China Hospital from April 2010 to December 2019. Radiomics features were extracted from pre-treatment contrast-enhanced T1 weighted imaging (T1C). Nine diagnostic models were established with three selection methods [Distance Correlation, least absolute shrinkage, and selection operator (LASSO), and Gradient Boosting Decision Tree (GBDT)] and three classification algorithms [Linear Discriminant Analysis (LDA), Support Vector Machine (SVM), and random forest (RF)]. The sensitivity, specificity, accuracy, and areas under receiver operating characteristic curve (AUC) of each model were calculated. Diagnostic ability of each model was evaluated based on these indexes. Results: Nine radiomics-based machine learning models with promising diagnostic performances were established. For LDA-based models, the optimal one was the combination of LASSO + LDA with AUC of 0.825. For SVM-based modes, Distance Correlation + SVM represented the most promising diagnostic performance with AUC of 0.808. And for RF-based models, Distance Correlation + RF were observed to be the optimal model with AUC of 0.821. Conclusion: Radiomic-based machine-learning has the potential to be utilized in differentiating atypical LGA from AA with reliable diagnostic performance. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the value of multiple machine learning methods in classifying pathological grades (G1,G2, and G3), and to provide the best machine learning method for the identification of pathological grades of pancreatic neuroendocrine tumors (PNETs) based on radiomics. Materials and Methods: A retrospective study was conducted on 82 patients with Pancreatic Neuroendocrine tumors. All patients had definite pathological diagnosis and grading results. Using Lifex software to extract the radiomics features from CT images manually. The sensitivity, specificity, area under the curve (AUC) and accuracy were used to evaluate the performance of the classification model. Result: Our analysis shows that the CT based radiomics features combined with multi algorithm machine learning method has a strong ability to identify the pathological grades of pancreatic neuroendocrine tumors. DC + AdaBoost, DC + GBDT, and Xgboost+RF were very valuable for the differential diagnosis of three pathological grades of PNET. They showed a strong ability to identify the pathological grade of pancreatic neuroendocrine tumors. The validation set AUC of DC + AdaBoost is 0.82 (G1 vs G2), 0.70 (G2 vs G3), and 0.85 (G1 vs G3), respectively. Conclusion: In conclusion, based on enhanced CT radiomics features could differentiate between different pathological grades of pancreatic neuroendocrine tumors. Feature selection method Distance Correlation + classifier method Adaptive Boosting show a good application prospect. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the current study was to evaluate the ability of magnetic resonance (MR) radiomics-based machine-learning algorithms in differentiating glioblastoma (GBM) from primary central nervous system lymphoma (PCNSL). Method: One-hundred and thirty-eight patients were enrolled in this study. Radiomics features were extracted from contrast-enhanced MR images, and the machine-learning models were established using five selection methods (distance correlation, random forest, least absolute shrinkage and selection operator (LASSO), eXtreme gradient boosting (Xgboost), and Gradient Boosting Decision Tree) and three radiomics-based machine-learning classifiers [linear discriminant analysis (LDA), support vector machine (SVM), and logistic regression (LR)]. Sensitivity, specificity, accuracy, and areas under curves (AUC) of models were calculated, with which the performances of classifiers were evaluated and compared with each other. Result: Brilliant discriminative performance would be observed among all classifiers when combined with the suitable selection method. For LDA-based models, the optimal one was Distance Correlation + LDA with AUC of 0.978. For SVM-based models, Distance Correlation + SVM was the one with highest AUC of 0.959, while for LR-based models, the highest AUC was 0.966 established with LASSO + LR. Conclusion: Radiomics-based machine-learning algorithms potentially have promising performances in differentiating GBM from PCNSL. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate the diagnostic value of machine-learning models with radiomic features and clinical features in preoperative differentiation of common lesions located in the anterior skull base. Methods: A total of 235 patients diagnosed with pituitary adenoma, meningioma, craniopharyngioma, or Rathke cleft cyst were enrolled in the current study. The discrimination was divided into three groups: pituitary adenoma vs. craniopharyngioma, meningioma vs. craniopharyngioma, and pituitary adenoma vs. Rathke cleft cyst. In each group, five selection methods were adopted to select suitable features for the classifier, and nine machine-learning classifiers were employed to build discriminative models. The diagnostic performance of each combination was evaluated with area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity calculated for both the training group and the testing group. Results: In each group, several classifiers combined with suitable selection methods represented feasible diagnostic performance with AUC of more than 0.80. Moreover, the combination of least absolute shrinkage and selection operator as the feature-selection method and linear discriminant analysis as the classification algorithm represented the best comprehensive discriminative ability. Conclusion: Radiomics-based machine learning could potentially serve as a novel method to assist in discriminating common lesions in the anterior skull base prior to operation. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the ability of radiomics features from MRI in differentiating anaplastic oligodendroglioma (AO) from atypical low-grade oligodendroglioma using machine-learning algorithms. Methods: A total number of 101 qualified patients (50 participants with AO and 51 with atypical low-grade oligodendroglioma) were enrolled in this retrospective, single-center study. Forty radiomics features of tumor images derived from six matrices were extracted from contrast-enhanced T1-weighted (T1C) images and fluid-attenuation inversion recovery (FLAIR) images. Three selection methods were performed to select the optimal features for classifiers, including distance correlation, least absolute shrinkage and selection operator (LASSO), and gradient boosting decision tree (GBDT). Then three machine-learning classifiers were adopted to generate discriminative models, including linear discriminant analysis, support vector machine, and random forest (RF). Receiver operating characteristic analysis was conducted to evaluate the discriminative performance of each model. Results: Nine predictive models were established based on radiomics features from T1C images and FLAIR images. All of the classifiers represented feasible ability in differentiation, with AUC more than 0.840 when combined with suitable selection method. For models based on T1C images, the combination of LASSO and RF classifier represented the highest AUC of 0.904 in the validation group. For models based on FLAIR images, the combination of GBDT and RF classifier showed the highest AUC of 0.861 in the validation group. Conclusion: Radiomics-based machine-learning approach could potentially serve as a feasible method in distinguishing AO from atypical low-grade oligodendroglioma. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the current study is to investigate whether texture analysis-based machine learning algorithms could help devise a non-invasive imaging biomarker for accurate classification of meningiomas using machine learning algorithms. Method: The study cohort was established from the hospital database by reviewing the medical records. Patients were selected if they underwent meningioma resection in the neurosurgery department between January 2015 and December 2018. A total number of 40 texture parameters were extracted from pretreatment postcontrast T1-weighted (T1C) images based on six matrixes. Three feature selection methods were adopted, namely, distance correlation, least absolute shrinkage and selection operator (LASSO), and gradient boosting decision tree (GBDT). Multiclass classification methods of linear discriminant analysis (LDA) and support vector machine (SVM) algorithms were employed to establish the classification models. The diagnostic performances of models were evaluated with confusion matrix based on which the areas under the curve, accuracy, and Kappa value of models were calculated. Result: Confusion matrix showed that the LDA-based models represented better diagnostic performances than SVM-based models. The highest accuracy among LDA-based models was 75.6%, shown in the combination of Lasso + LDA. The optimal models for SVM-based models was Lasso+SVM, with accuracy of 59.0% in the testing group. One of the SVM-based models, GBDT+SVM, was overfitting, suggesting that this model was not suitable for application. Conclusion: Machine learning algorithms with texture features extracted from T1C images could potentially serve as the assistant imaging biomarkers for presurgically grading meningiomas. [ABSTRACT FROM AUTHOR]

Purpose: To investigative the diagnostic performance of radiomics-based machine learning in differentiating glioblastomas (GBM) from metastatic brain tumors (MBTs). Method: The current study involved 134 patients diagnosed and treated in our institution between April 2014 and December 2018. Radiomics features were extracted from contrast-enhanced T1 weighted imaging (T1C). Thirty diagnostic models were built based on five selection methods and six classification algorithms. The sensitivity, specificity, accuracy, and area under curve (AUC) of each model were calculated, and based on these the optimal model was chosen. Result : Two models represented promising diagnostic performance with AUC of 0.80. The first model was a combination of Distance Correlation as the selection method and Linear Discriminant Analysis (LDA) as the classification algorithm. In the training group, the sensitivity, specificity, accuracy, and AUC were 0.75, 0.85, 0.80, and 0.80, respectively; and in the testing group, the sensitivity, specificity, accuracy, and AUC of the model were 0.69, 0.86, 0.78, and 0.80, respectively. The second model was the Distance Correlation as the selection method and logistic regression (LR) as the classification algorithm, with sensitivity, specificity, accuracy, and AUC of 0.75, 0.85, 0.80, 0.80 in the training group and 0.69, 0.86, 0.78, 0.80 in the testing group. Conclusion: Radiomic-based machine learning has potential to be utilized in differentiating GBM from MBTs. [ABSTRACT FROM AUTHOR]

For the tumors located in the anterior skull base, germinoma and craniopharyngioma (CP) are unusual types with similar clinical manifestations and imaging features. The difference in treatment strategies and outcomes of patients highlights the importance of making an accurate preoperative diagnosis. This retrospective study enrolled 107 patients diagnosed with germinoma (n = 44) and CP (n = 63). The region of interest (ROI) was drawn independently by two researchers. Radiomic features were extracted from contrast-enhanced T1WI and T2WI sequences. Here, we established the diagnosis models with a combination of three selection methods, as well as three classifiers. After training the models, their performances were evaluated on the independent validation cohort and compared based on the index of the area under the receiver operating characteristic curve (AUC) in the validation cohort. Nine models were established and compared to find the optimal one defined with the highest AUC in the validation cohort. For the models applied in the contrast-enhanced T1WI images, RFS + RFC and LASSO + LDA were observed to be the optimal models with AUCs of 0.91. For the models applied in the T2WI images, DC + LDA and LASSO + LDA were observed to be the optimal models with AUCs of 0.88. The evidence of this study indicated that radiomics-based machine learning could be potentially considered as the radiological method in the presurgical differential diagnosis of germinoma and CP with a reliable diagnostic performance. [ABSTRACT FROM AUTHOR]

Preoperative prediction of visual recovery after pituitary adenoma surgery remains a challenge. We aimed to investigate the value of MRI-based radiomics of the optic chiasm in predicting postoperative visual field outcome using machine learning technology. A total of 131 pituitary adenoma patients were retrospectively enrolled and divided into the recovery group (N = 79) and the non-recovery group (N = 52) according to visual field outcome following surgical chiasmal decompression. Radiomic features were extracted from the optic chiasm on preoperative coronal T2-weighted imaging. Least absolute shrinkage and selection operator regression were first used to select optimal features. Then, three machine learning algorithms were employed to develop radiomic models to predict visual recovery, including support vector machine (SVM), random forest and linear discriminant analysis. The prognostic performances of models were evaluated via five-fold cross-validation. The results showed that radiomic models using different machine learning algorithms all achieved area under the curve (AUC) over 0.750. The SVM-based model represented the best predictive performance for visual field recovery, with the highest AUC of 0.824. In conclusion, machine learning-based radiomics of the optic chiasm on routine MR imaging could potentially serve as a novel approach to preoperatively predict visual recovery and allow personalized counseling for individual pituitary adenoma patients. [ABSTRACT FROM AUTHOR]