Walia Farzana

Walia Farzana, Mustafa M Basree, Norou Diawara et al.

Recent clinical research describes a subset of glioblastoma patients that exhibit REP prior to start of radiation therapy. Current literature has thus far described this population using clinicopathologic features. To our knowledge, this study is the first to investigate the potential of conventional ra-diomics, sophisticated multi-resolution fractal texture features, and different molecular features (MGMT, IDH mutations) as a diagnostic and prognostic tool for prediction of REP from non-REP cases using computational and statistical modeling methods. Radiation-planning T1 post-contrast (T1C) MRI sequences of 70 patients are analyzed. Ensemble method with 5-fold cross validation over 1000 iterations offers AUC of 0.793 with standard deviation of 0.082 for REP and non-REP classification. In addition, copula-based modeling under dependent censoring (where a subset of the patients may not be followed up until death) identifies significant features (p-value <0.05) for survival probability and prognostic grouping of patient cases. The prediction of survival for the patients cohort produces precision of 0.881 with standard deviation of 0.056. The prognostic index (PI) calculated using the fused features suggests that 84.62% of REP cases fall under the bad prognostic group, suggesting potentiality of fused features to predict a higher percentage of REP cases. The experimental result further shows that mul-ti-resolution fractal texture features perform better than conventional radiomics features for REP and survival outcomes.

M. S. Sadique, W. Farzana, A. Temtam et al.

GBM (Glioblastoma multiforme) is the most aggressive type of brain tumor in adults that has a short survival rate even after aggressive treatment with surgery and radiation therapy. The changes on magnetic resonance imaging (MRI) for patients with GBM after radiotherapy are indicative of either radiation-induced necrosis (RN) or recurrent brain tumor (rBT). Screening for rBT and RN at an early stage is crucial for facilitating faster treatment and better outcomes for the patients. Differentiating rBT from RN is challenging as both may present with similar radiological and clinical characteristics on MRI. Moreover, learning-based rBT versus RN classification using MRI may suffer from class imbalance due to lack of patient data. While synthetic data generation using generative models has shown promise to address class imbalance, the underlying data representation may be different in synthetic or augmented data. This study proposes computational modeling with statistically rigorous repeated random sub-sampling to balance the subset sample size for rBT and RN classification. The proposed pipeline includes multiresolution radiomic feature (MRF) extraction followed by feature selection with statistical significance testing (p<0.05). The five-fold cross validation results show the proposed model with MRF features classifies rBT from RN with an area under the curve (AUC) of 0.8920+-.055. Moreover, considering the dependence between survival time and censor time (where patients are not followed up until death), we demonstrate the feasibility of using MRF radiomic features as a non-invasive biomarker to identify patients who are at higher risk of recurrence or radiation necrosis. The cross-validated results show that the MRF model provides the best overall performance with an AUC of 0.770+-.032.

Michael L. Evans, MD Fayaz Bin Hossen, MD Shibly Sadique et al.

Accurate brain tumor segmentation from multiparametric magnetic resonance imaging (MRI) is critical for treatment planning, response assessment, and quantitative neuro-oncology research. However, automated segmentation remains a difficult task in computer vision because of variation in tumor appearance and MRI protocols across patient scans. Moreover, clinically important regions such as enhancing tumor (ET) and tumor core (TC) are often small relative to the full brain volume, furthering increasing the difficulty of achieving high voxel-level precision. In this paper, we show that combining a modern 3D convolutional segmentation model with corrective diffusion-based refinement and ensembling improves volumetric glioma segmentation on the UTSW-Glioma dataset. We propose CoMNeT, a MedNeXt-CorrDiff framework that uses four MRI modalities as input and predicts ET, TC, and whole tumor (WT) regions for automated brain tumor segmentation. MedNeXt is used as the primary segmentation model with Global Response Normalization for feature learning, while CorrDiff is trained as a postprocessing residual refinement method to correct errors in the probability maps before final thresholding. Using five-fold cross-validation, CoMNeT achieved the highest Dice score for most tumor regions, with ET, TC, WT, and average Dice scores of 0.7543 +/- 0.0261, 0.6806 +/- 0.0166, 0.9049 +/- 0.0128, and 0.7798 +/- 0.0184, respectively. CoMNeT outperformed two selected baseline models: SegResNet (0.7555 +/- 0.0190 average Dice) and standalone MedNeXt (0.7697 +/- 0.0154 average Dice). Our findings support the use of corrective diffusion and fold-level probability ensembling as practical additions to existing state-of-the-art 3D convolutional models for automated glioma segmentation.