Marjaneh Hejazi

Somayeh Farahani, Marjaneh Hejazi, Antonio Di Ieva et al.

Accurate, noninvasive glioma characterization is crucial for effective clinical management. Traditional methods, dependent on invasive tissue sampling, often fail to capture the spatial heterogeneity of the tumor. While deep learning has improved segmentation and molecular profiling, few approaches simultaneously integrate tumor morphology and molecular features. Foundation deep learning models, which learn robust, task-agnostic representations from large-scale datasets, hold great promise but remain underutilized in glioma imaging biomarkers. We propose the Multi-Task SWIN-UNETR (MTS-UNET) model, a novel foundation-based framework built on the BrainSegFounder model, pretrained on large-scale neuroimaging data. MTS-UNET simultaneously performs glioma segmentation, histological grading, and molecular subtyping (IDH mutation and 1p/19q co-deletion). It incorporates two key modules: Tumor-Aware Feature Encoding (TAFE) for multi-scale, tumor-focused feature extraction and Cross-Modality Differential (CMD) for highlighting subtle T2-FLAIR mismatch signals associated with IDH mutation. The model was trained and validated on a diverse, multi-center cohort of 2,249 glioma patients from seven public datasets. MTS-UNET achieved a mean Dice score of 84% for segmentation, along with AUCs of 90.58% for IDH mutation, 69.22% for 1p/19q co-deletion prediction, and 87.54% for grading, significantly outperforming baseline models (p<=0.05). Ablation studies validated the essential contributions of the TAFE and CMD modules and demonstrated the robustness of the framework. The foundation-based MTS-UNET model effectively integrates tumor segmentation with multi-level classification, exhibiting strong generalizability across diverse MRI datasets. This framework shows significant potential for advancing noninvasive, personalized glioma management by improving predictive accuracy and interpretability.

Somayeh Farahani, Marjaneh Hejazi, Antonio Di Ieva et al.

Accurate, noninvasive detection of isocitrate dehydrogenase (IDH) mutation is essential for effective glioma management. Traditional methods rely on invasive tissue sampling, which may fail to capture a tumor's spatial heterogeneity. While deep learning models have shown promise in molecular profiling, their performance is often limited by scarce annotated data. In contrast, foundation deep learning models offer a more generalizable approach for glioma imaging biomarkers. We propose a Foundation-based Biomarker Network (FoundBioNet) that utilizes a SWIN-UNETR-based architecture to noninvasively predict IDH mutation status from multi-parametric MRI. Two key modules are incorporated: Tumor-Aware Feature Encoding (TAFE) for extracting multi-scale, tumor-focused features, and Cross-Modality Differential (CMD) for highlighting subtle T2-FLAIR mismatch signals associated with IDH mutation. The model was trained and validated on a diverse, multi-center cohort of 1705 glioma patients from six public datasets. Our model achieved AUCs of 90.58%, 88.08%, 65.41%, and 80.31% on independent test sets from EGD, TCGA, Ivy GAP, RHUH, and UPenn, consistently outperforming baseline approaches (p <= 0.05). Ablation studies confirmed that both the TAFE and CMD modules are essential for improving predictive accuracy. By integrating large-scale pretraining and task-specific fine-tuning, FoundBioNet enables generalizable glioma characterization. This approach enhances diagnostic accuracy and interpretability, with the potential to enable more personalized patient care.

Somayeh Farahani, Marjaneh Hejazi, Mehnaz Tabassum et al.

Objectives We aimed to evaluate the diagnostic performance of deep learning (DL)-based radiomics models for the noninvasive prediction of isocitrate dehydrogenase (IDH) mutation and 1p/19q co-deletion status in glioma patients using MRI sequences, and to identify methodological factors influencing accuracy and generalizability. Materials and methods Following PRISMA guidelines, we systematically searched major databases (PubMed, Scopus, Embase, Web of Science, and Google Scholar) up to March 2025, screening studies that utilized DL to predict IDH and 1p/19q co-deletion status from MRI data. We assessed study quality and risk of bias using the Radiomics Quality Score and the QUADAS-2 tool. Our meta-analysis employed a bivariate model to compute pooled sensitivity and specificity, and meta-regression to assess interstudy heterogeneity. Results Among the 1517 unique publications, 104 were included in the qualitative synthesis, and 72 underwent meta-analysis. Pooled estimates for IDH prediction in test cohorts yielded a sensitivity of 0.80 and specificity of 0.85. For 1p/19q co-deletion, sensitivity was 0.75 and specificity was 0.82. Meta-regression identified the tumor segmentation method and the extent of DL integration into the radiomics pipeline as significant contributors to interstudy variability. Conclusion Although DL models demonstrate strong potential for noninvasive molecular classification of gliomas, clinical translation requires several critical steps: harmonization of multi-center MRI data using techniques such as histogram matching and DL-based style transfer; adoption of standardized and automated segmentation protocols; extensive multi-center external validation; and prospective clinical validation.