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Deep learning for glioblastoma segmentation using preoperative magnetic resonance imaging identifies volumetric features associated with survival.

Accepted version
Peer-reviewed

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Article

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Authors

Rahmat, Roushanak 
Price, Stephen J 

Abstract

BACKGROUND: Measurement of volumetric features is challenging in glioblastoma. We investigate whether volumetric features derived from preoperative MRI using a convolutional neural network-assisted segmentation is correlated with survival. METHODS: Preoperative MRI of 120 patients were scored using Visually Accessible Rembrandt Images (VASARI) features. We trained and tested a multilayer, multi-scale convolutional neural network on multimodal brain tumour segmentation challenge (BRATS) data, prior to testing on our dataset. The automated labels were manually edited to generate ground truth segmentations. Network performance for our data and BRATS data was compared. Multivariable Cox regression analysis corrected for multiple testing using the false discovery rate was performed to correlate clinical and imaging variables with overall survival. RESULTS: Median Dice coefficients in our sample were (1) whole tumour 0.94 (IQR, 0.82-0.98) compared to 0.91 (IQR, 0.83-0.94 p = 0.012), (2) FLAIR region 0.84 (IQR, 0.63-0.95) compared to 0.81 (IQR, 0.69-0.8 p = 0.170), (3) contrast-enhancing region 0.91 (IQR, 0.74-0.98) compared to 0.83 (IQR, 0.78-0.89 p = 0.003) and (4) necrosis region were 0.82 (IQR, 0.47-0.97) compared to 0.67 (IQR, 0.42-0.81 p = 0.005). Contrast-enhancing region/tumour core ratio (HR 4.73 [95% CI, 1.67-13.40], corrected p = 0.017) and necrotic core/tumour core ratio (HR 8.13 [95% CI, 2.06-32.12], corrected p = 0.011) were independently associated with overall survival. CONCLUSION: Semi-automated segmentation of glioblastoma using a convolutional neural network trained on independent data is robust when applied to routine clinical data. The segmented volumes have prognostic significance.

Description

Keywords

Deep learning, Glioblastoma, MRI, Segmentation, Survival, Volumetric, Aged, Brain Neoplasms, Deep Learning, Female, Glioblastoma, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Neural Networks, Computer, Treatment Outcome

Journal Title

Acta Neurochir (Wien)

Conference Name

Journal ISSN

0001-6268
0942-0940

Volume Title

162

Publisher

Springer Science and Business Media LLC

Rights

All rights reserved
Sponsorship
Department of Health (via National Institute for Health Research (NIHR)) (CDF-2018-11-ST2-003)
NIHR Academy (CDF-2018-11-ST2-003)
NIHR Career Development Fellowship (for me) - CDF-2018-11-ST2-003