Predicting survival in glioblastoma with multimodal neuroimaging and machine learning

Author:

Luckett Patrick H.ORCID,Olufawo Michael,Lamichhane Bidhan,Park Ki Yun,Dierker Donna,Verastegui Gabriel Trevino,Yang Peter,Kim Albert H.,Chheda Milan G.,Snyder Abraham Z.,Shimony Joshua S.,Leuthardt Eric C.

Abstract

Abstract Purpose Glioblastoma (GBM) is the most common and aggressive malignant glioma, with an overall median survival of less than two years. The ability to predict survival before treatment in GBM patients would lead to improved disease management, clinical trial enrollment, and patient care. Methods GBM patients (N = 133, mean age 60.8 years, median survival 14.1 months, 57.9% male) were retrospectively recruited from the neurosurgery brain tumor service at Washington University Medical Center. All patients completed structural neuroimaging and resting state functional MRI (RS-fMRI) before surgery. Demographics, measures of cortical thickness (CT), and resting state functional network connectivity (FC) were used to train a deep neural network to classify patients based on survival (< 1y, 1-2y, >2y). Permutation feature importance identified the strongest predictors of survival based on the trained models. Results The models achieved a combined cross-validation and hold out accuracy of 90.6% in classifying survival (< 1y, 1-2y, >2y). The strongest demographic predictors were age at diagnosis and sex. The strongest CT predictors of survival included the superior temporal sulcus, parahippocampal gyrus, pericalcarine, pars triangularis, and middle temporal regions. The strongest FC features primarily involved dorsal and inferior somatomotor, visual, and cingulo-opercular networks. Conclusion We demonstrate that machine learning can accurately classify survival in GBM patients based on multimodal neuroimaging before any surgical or medical intervention. These results were achieved without information regarding presentation symptoms, treatments, postsurgical outcomes, or tumor genomic information. Our results suggest GBMs have a global effect on the brain’s structural and functional organization, which is predictive of survival.

Funder

Washington University Yearlong Research Program Dean’s Fellowship

National Cancer Institute

National Institute of Neurological Disorders and Stroke

National Institute of Biomedical Imaging and Bioengineering

Publisher

Springer Science and Business Media LLC

Subject

Cancer Research,Neurology (clinical),Neurology,Oncology

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