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Comparative analysis of deep learning and radiomic signatures for overall survival prediction in recurrent high-grade

Qi Wan1,2, Clifford Lindsay3, Chenxi Zhang4

  • 1Department of Radiology, the Key Laboratory of Advanced Interdisciplinary Studies Center, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. qiwan@gzhmu.edu.cn.

Cancer Imaging : the Official Publication of the International Cancer Imaging Society
|January 22, 2025
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Summary

Manual segmentation radiomic features better predict survival in glioma patients than automated methods. An end-to-end deep learning model showed similar performance without segmentation, offering a potential time-saving alternative.

Keywords:
Convolutional neural networksDeep learningHigh-grade gliomaOverall survivalRadiomics

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Area of Science:

  • Radiology and Medical Imaging
  • Oncology
  • Artificial Intelligence in Medicine

Background:

  • Radiomic analysis aids prognosis prediction in brain tumor patients.
  • Manual tumor segmentation is time-consuming and lacks reproducibility.
  • This study compares manual and automated segmentation for predicting overall survival (OS) in recurrent high-grade glioma (HGG) patients undergoing immunotherapy.

Purpose of the Study:

  • To compare the predictive performance of radiomic features derived from manual versus automated (CNN) segmentation for overall survival (OS) in recurrent high-grade glioma (HGG) patients.
  • To evaluate an end-to-end deep learning (DL) model for OS prediction in the same patient cohort.
  • To assess the impact of robust feature selection on prediction accuracy.

Main Methods:

  • Retrospective analysis of 154 recurrent HGG cases.
  • Tumor segmentation using expert radiologists and a convolutional neural network (CNN).
  • Extraction and selection of 2553 radiomic features, with robust subset selection.
  • Support Vector Machine (SVM) for radiomics-based OS prediction and CNN for direct classification.
  • Ten-fold cross-validation and rotating test set for model validation.

Main Results:

  • Manual segmentation-derived radiomics achieved higher OS prediction accuracy (AUC 0.662) than automated segmentation (AUC 0.471) in the test set.
  • Robust feature selection improved manual segmentation performance (AUC 0.700) and automated segmentation performance (AUC 0.554).
  • The end-to-end CNN prognosis model demonstrated comparable performance to manual radiomics (AUC 0.700).

Conclusions:

  • Radiomic features from manual segmentation are superior for predicting OS in HGG patients undergoing immunotherapy.
  • An end-to-end CNN model offers comparable predictive performance to manual radiomics without requiring segmentation.
  • The trade-off between time-saving automated methods and the interpretability of manual segmentation requires consideration.