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  • 1
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    Online Resource
    Pseudoprogression prediction in high grade primary CNS tumors by use of radiomics
    Springer Science and Business Media LLC ; 2022
    In:  Scientific Reports Vol. 12, No. 1 ( 2022-04-08)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 12, No. 1 ( 2022-04-08)
    Abstract: Our aim is to define the capabilities of radiomics and machine learning in predicting pseudoprogression development from pre-treatment MR images in a patient cohort diagnosed with high grade gliomas. In this retrospective analysis, we analysed 131 patients with high grade gliomas. Segmentation of the contrast enhancing parts of the tumor before administration of radio-chemotherapy was semi-automatically performed using the 3D Slicer open-source software platform (version 4.10) on T1 post contrast MR images. Imaging data was split into training data, test data and an independent validation sample at random. We extracted a total of 107 radiomic features by hand-delineated regions of interest (ROI). Feature selection and model construction were performed using Generalized Boosted Regression Models (GBM). 131 patients were included, of which 64 patients had a histopathologically proven progressive disease and 67 were diagnosed with mixed or pure pseudoprogression after initial treatment. Our Radiomics approach is able to predict the occurrence of pseudoprogression with an AUC, mean sensitivity, mean specificity and mean accuracy of 91.49% [86.27%, 95.89%] , 79.92% [73.08%, 87.55%], 88.61% [85.19%, 94.44%] and 84.35% [80.19%, 90.57%] in the full development group, 78.51% [75.27%, 82.46%] , 66.26% [57.95%, 73.02%], 78.31% [70.48%, 84.19%] and 72.40% [68.06%, 76.85%] in the testing group and finally 72.87% [70.18%, 76.28%] , 71.75% [62.29%, 75.00%], 80.00% [69.23%, 84.62%] and 76.04% [69.90%, 80.00%] in the independent validation sample, respectively. Our results indicate that radiomics is a promising tool to predict pseudo-progression, thus potentially allowing to reduce the use of biopsies and invasive histopathology.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-022-09945-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2615211-3
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  • 2
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    Online Resource
    Vasculitis and Ischemic Stroke in Lyme Neuroborreliosis—Interventional Management Approach and Literature Review
    MDPI AG ; 2023
    In:  Brain Sciences Vol. 13, No. 10 ( 2023-09-29), p. 1388-
    Details
    In: Brain Sciences, MDPI AG, Vol. 13, No. 10 ( 2023-09-29), p. 1388-
    Abstract: Objective: In rare cases, Lyme neuroborreliosis (LNB) can induce cerebral vasculitis leading to severe stenosis of the cerebral vasculature and consecutive ischemia. Therapy is based on anti-biotic treatment of the tick-borne disease, whereas interventional therapeutic options have not been assessed yet. Material and Methods: We report on a patient with LNB and concomitant stenoses and progressive and fatal vasculitis of the cerebral vessels despite all therapeutic efforts by the departments of neurology and interventional neuroradiology. In this context, we also conducted a literature review on endovascular treatment of LNB-associated cerebral ischemia. Results: A 52-year-old female presented with transient neglect and psychomotor slowdown (initial NIHSS = 0). MRI and serology led to the diagnosis of basal meningitis due to LNB with vasculitis of cerebral arteries. Despite immediate treatment with antibiotics and steroids, neurologic deterioration (NIHSS 8) led to an emergency angiography on day 2 after admission. Hemodynamically relevant stenoses of the MCA were treated via spasmolysis and PTA, leading to almost complete neurological recovery. Despite intensified medical treatment, the vasculitis progressed and could only be transiently ameliorated via repetitive spasmolysis. On day 19, she again presented with significant neurologic deterioration (NIHSS 9), and PTA and stenting of the nearly occluded MCA were performed with a patent vessel, initially without hemorrhagic complications. Despite all therapeutic efforts and preserved stent perfusion, vasculitis worsened and the concurrent occurrence of subdural hemorrhage led to the death of the patient. Conclusion: Neuroradiological interventions, i.e., spasmolysis, PTA, and, if necessary, stenting, can and should be considered in cases of LNB-induced vasculitis and stroke that are refractory to best medical treatment alone. Key point: Neuroradiological interventions can be considered in patients with vascular complications of Lyme neuroborreliosis as an additional extension of the primary drug therapy.
    Type of Medium: Online Resource
    ISSN: 2076-3425
    URL: Article
    DOI: 10.3390/brainsci13101388
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2651993-8
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  • 3
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    Testing the applicability and performance of Auto ML for potential applications in diagnostic neuroradiology
    Springer Science and Business Media LLC ; 2022
    In:  Scientific Reports Vol. 12, No. 1 ( 2022-08-11)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 12, No. 1 ( 2022-08-11)
    Abstract: To investigate the applicability and performance of automated machine learning (AutoML) for potential applications in diagnostic neuroradiology. In the medical sector, there is a rapidly growing demand for machine learning methods, but only a limited number of corresponding experts. The comparatively simple handling of AutoML should enable even non-experts to develop adequate machine learning models with manageable effort. We aim to investigate the feasibility as well as the advantages and disadvantages of developing AutoML models compared to developing conventional machine learning models. We discuss the results in relation to a concrete example of a medical prediction application. In this retrospective IRB-approved study, a cohort of 107 patients who underwent gross total meningioma resection and a second cohort of 31 patients who underwent subtotal resection were included. Image segmentation of the contrast enhancing parts of the tumor was performed semi-automatically using the open-source software platform 3D Slicer. A total of 107 radiomic features were extracted by hand-delineated regions of interest from the pre-treatment MRI images of each patient. Within the AutoML approach, 20 different machine learning algorithms were trained and tested simultaneously. For comparison, a neural network and different conventional machine learning algorithms were trained and tested. With respect to the exemplary medical prediction application used in this study to evaluate the performance of Auto ML, namely the pre-treatment prediction of the achievable resection status of meningioma, AutoML achieved remarkable performance nearly equivalent to that of a feed-forward neural network with a single hidden layer. However, in the clinical case study considered here, logistic regression outperformed the AutoML algorithm. Using independent test data, we observed the following classification results (AutoML/neural network/logistic regression): mean area under the curve = 0.849/0.879/0.900, mean accuracy = 0.821/0.839/0.881, mean kappa = 0.465/0.491/0.644, mean sensitivity = 0.578/0.577/0.692 and mean specificity = 0.891/0.914/0.936. The results obtained with AutoML are therefore very promising. However, the AutoML models in our study did not yet show the corresponding performance of the best models obtained with conventional machine learning methods. While AutoML may facilitate and simplify the task of training and testing machine learning algorithms as applied in the field of neuroradiology and medical imaging, a considerable amount of expert knowledge may still be needed to develop models with the highest possible discriminatory power for diagnostic neuroradiology.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-022-18028-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2615211-3
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  • 4
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    Online Resource
    Assessing preoperative risk of STR in skull meningiomas using MR radiomics and machine learning
    Springer Science and Business Media LLC ; 2022
    In:  Scientific Reports Vol. 12, No. 1 ( 2022-08-18)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 12, No. 1 ( 2022-08-18)
    Abstract: Our aim is to predict possible gross total and subtotal resections of skull meningiomas from pre-treatment T1 post contrast MR-images using radiomics and machine learning in a representative patient cohort. We analyse the accuracy of our model predictions depending on the tumor location within the skull and the postoperative tumor volume. In this retrospective, IRB-approved study, image segmentation of the contrast enhancing parts of the tumor was semi-automatically performed using the 3D Slicer open-source software platform. Imaging data were split into training data and independent test data at random. We extracted a total of 107 radiomic features by hand-delineated regions of interest on T1 post contrast MR images. Feature preselection and model construction were performed with eight different machine learning algorithms. Each model was estimated 100 times on new training data and then tested on a previously unknown, independent test data set to avoid possible overfitting. Our cohort included 138 patients. A gross total resection of the meningioma was performed in 107 cases and a subtotal resection in the remaining 31 cases. Using the training data, the mean area under the curve (AUC), mean accuracy, mean kappa, mean sensitivity and mean specificity were 0.901, 0.875, 0.629, 0.675 and 0.933 respectively. We obtained very similar results with the independent test data: mean AUC = 0.900, mean accuracy = 0.881, mean kappa = 0.644, mean sensitivity = 0.692 and mean specificity = 0.936. Thus, our model exposes good and stable predictive performance with both training and test data. Our radiomics approach shows that with machine learning algorithms and comparatively few explanatory factors such as the location of the tumor within the skull as well as its shape, it is possible to make accurate predictions about whether a meningioma can be completely resected by surgery. Complete resections and resections with larger postoperative tumor volumes can be predicted with very high accuracy. However, cases with very small postoperative tumor volumes are comparatively difficult to predict correctly.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-022-18458-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2615211-3
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  • 5
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    Use Test of Automated Machine Learning in Cancer Diagnostics
    MDPI AG ; 2023
    In:  Diagnostics Vol. 13, No. 14 ( 2023-07-08), p. 2315-
    Details
    In: Diagnostics, MDPI AG, Vol. 13, No. 14 ( 2023-07-08), p. 2315-
    Abstract: Our aim is to investigate the added value of automated machine learning (AutoML) for potential future applications in cancer diagnostics. Using two important diagnostic questions, the non-invasive determination of IDH mutation status and ATRX status, we analyze whether it is possible to use AutoML to develop models that are comparable in performance to conventional machine learning models (ML) developed by experts. For this purpose, we develop AutoML models using different feature preselection methods and compare the results with previously developed conventional ML models. The cohort used for our study comprises T2-weighted MRI images of 124 patients with histologically confirmed gliomas. Using AutoML, we were able to develop sophisticated models in a very short time with only a few lines of computer code. In predicting IDH mutation status, we obtained a mean AUC of 0.7400 and a mean AUPRC of 0.8582. ATRX mutation status was predicted with very similar discriminatory power, with a mean AUC of 0.7810 and a mean AUPRC of 0.8511. In both cases, AutoML was even able to achieve a discriminatory power slightly above that of the respective conventionally developed models in a very short computing time, thus making such methods accessible to non-experts in the near future.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics13142315
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662336-5
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  • 6
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    Comparison of MRI Sequences to Predict ATRX Status Using Radiomics-Based Machine Learning
    MDPI AG ; 2023
    In:  Diagnostics Vol. 13, No. 13 ( 2023-06-29), p. 2216-
    Details
    In: Diagnostics, MDPI AG, Vol. 13, No. 13 ( 2023-06-29), p. 2216-
    Abstract: ATRX is an important molecular marker according to the 2021 WHO classification of adult-type diffuse glioma. We aim to predict the ATRX mutation status non-invasively using radiomics-based machine learning models on MRI and to determine which MRI sequence is best suited for this purpose. In this retrospective study, we used MRI images of patients with histologically confirmed glioma, including the sequences T1w without and with the administration of contrast agent, T2w, and the FLAIR. Radiomics features were extracted from the corresponding MRI images by hand-delineated regions of interest. Data partitioning into training data and independent test data was repeated 100 times to avoid random effects. Feature preselection and subsequent model development were performed using Lasso regression. The T2w sequence was found to be the most suitable and the FLAIR sequence the least suitable for predicting ATRX mutations using radiomics-based machine learning models. For the T2w sequence, our seven-feature model developed with Lasso regression achieved a mean AUC of 0.831, a mean accuracy of 0.746, a mean sensitivity of 0.772, and a mean specificity of 0.697. In conclusion, for the prediction of ATRX mutation using radiomics-based machine learning models, the T2w sequence is the most suitable among the commonly used MRI sequences.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics13132216
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662336-5
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  • 7
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    Online Resource
    Radiomics for pseudoprogression prediction in high grade gliomas: added value of MR contrast agent
    Elsevier BV ; 2022
    In:  Heliyon Vol. 8, No. 8 ( 2022-08), p. e10023-
    Details
    In: Heliyon, Elsevier BV, Vol. 8, No. 8 ( 2022-08), p. e10023-
    Type of Medium: Online Resource
    ISSN: 2405-8440
    URL: Article
    DOI: 10.1016/j.heliyon.2022.e10023
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2835763-2
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