WHO 2016 subtyping and automated segmentation of glioma using multi-task deep learning

Accurate characterization of glioma is crucial for clinical decision making. A delineation of the tumor is also desirable in the initial decision stages but is a time-consuming task. Leveraging the latest GPU capabilities, we developed a single multi-task convolutional neural network that uses the full 3D, structural, pre-operative MRI scans to can predict the IDH mutation status, the 1p/19q co-deletion status, and the grade of a tumor, while simultaneously segmenting the tumor. We trained our method using the largest, most diverse patient cohort to date containing 1508 glioma patients from 16 institutes. We tested our method on an independent dataset of 240 patients from 13 different institutes, and achieved an IDH-AUC of 0.90, 1p/19q-AUC of 0.85, grade-AUC of 0.81, and a mean whole tumor DICE score of 0.84. Thus, our method non-invasively predicts multiple, clinically relevant parameters and generalizes well to the broader clinical population.

[1]  Z L Gokaslan,et al.  Limitations of stereotactic biopsy in the initial management of gliomas. , 2001, Neuro-oncology.

[2]  David J. Hand,et al.  A Simple Generalisation of the Area Under the ROC Curve for Multiple Class Classification Problems , 2001, Machine Learning.

[3]  B. Scheithauer,et al.  The 2007 WHO classification of tumours of the central nervous system , 2007, Acta Neuropathologica.

[4]  C. Almli,et al.  Unbiased nonlinear average age-appropriate brain templates from birth to adulthood , 2009, NeuroImage.

[5]  Yin-Cheng Huang,et al.  Stereotactic brain biopsy: Single center retrospective analysis of complications , 2009, Clinical Neurology and Neurosurgery.

[6]  M. J. van den Bent Interobserver variation of the histopathological diagnosis in clinical trials on glioma: a clinician’s perspective , 2010, Acta neuropathologica.

[7]  K. Hoang-Xuan,et al.  All the 1p19q codeleted gliomas are mutated on IDH1 or IDH2 , 2010, Neurology.

[8]  Max A. Viergever,et al.  elastix: A Toolbox for Intensity-Based Medical Image Registration , 2010, IEEE Transactions on Medical Imaging.

[9]  Gaël Varoquaux,et al.  Scikit-learn: Machine Learning in Python , 2011, J. Mach. Learn. Res..

[10]  D. Louis Collins,et al.  Unbiased average age-appropriate atlases for pediatric studies , 2011, NeuroImage.

[11]  T. Cloughesy,et al.  Relationship between Tumor Enhancement, Edema, IDH1 Mutational Status, MGMT Promoter Methylation, and Survival in Glioblastoma , 2012, American Journal of Neuroradiology.

[12]  Stephen M. Moore,et al.  The Cancer Imaging Archive (TCIA): Maintaining and Operating a Public Information Repository , 2013, Journal of Digital Imaging.

[13]  Luis Ibáñez,et al.  The Design of SimpleITK , 2013, Front. Neuroinform..

[14]  W. Shi,et al.  Diffusion-Weighted MR Imaging and MGMT Methylation Status in Glioblastoma: A Reappraisal of the Role of Preoperative Quantitative ADC Measurements , 2013, American Journal of Neuroradiology.

[15]  Stefan Klein,et al.  Fast parallel image registration on CPU and GPU for diagnostic classification of Alzheimer's disease , 2013, Front. Neuroinform..

[16]  P. Lambin,et al.  Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach , 2014, Nature Communications.

[17]  Alexander R. Pico,et al.  Glioma Groups Based on 1p/19q, IDH, and TERT Promoter Mutations in Tumors. , 2015, The New England journal of medicine.

[18]  Allan Hanbury,et al.  Metrics for evaluating 3D medical image segmentation: analysis, selection, and tool , 2015, BMC Medical Imaging.

[19]  Brian B. Avants,et al.  The Multimodal Brain Tumor Image Segmentation Benchmark (BRATS) , 2015, IEEE Transactions on Medical Imaging.

[20]  G. Reifenberger,et al.  The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary , 2016, Acta Neuropathologica.

[21]  Marion Smits,et al.  Imaging of oligodendroglioma , 2016, The British journal of radiology.

[22]  Yuan Yu,et al.  TensorFlow: A system for large-scale machine learning , 2016, OSDI.

[23]  Christopher Rorden,et al.  The first step for neuroimaging data analysis: DICOM to NIfTI conversion , 2016, Journal of Neuroscience Methods.

[24]  Pieter Wesseling,et al.  Molecular classification of anaplastic oligodendroglioma using next-generation sequencing: a report of the prospective randomized EORTC Brain Tumor Group 26951 phase III trial. , 2016, Neuro-oncology.

[25]  Paul Kinahan,et al.  Radiomics: Images Are More than Pictures, They Are Data , 2015, Radiology.

[26]  H. Aerts,et al.  Applications and limitations of radiomics , 2016, Physics in medicine and biology.

[27]  Karra A. Jones,et al.  Imaging correlates for the 2016 update on WHO classification of grade II/III gliomas: implications for IDH, 1p/19q and ATRX status , 2017, Journal of Neuro-Oncology.

[28]  Olaf Ronneberger,et al.  Invited Talk: U-Net Convolutional Networks for Biomedical Image Segmentation , 2017, Bildverarbeitung für die Medizin.

[29]  Christos Davatzikos,et al.  Advancing The Cancer Genome Atlas glioma MRI collections with expert segmentation labels and radiomic features , 2017, Scientific Data.

[30]  Martin Wattenberg,et al.  SmoothGrad: removing noise by adding noise , 2017, ArXiv.

[31]  Massimo Bellomi,et al.  Radiomics: the facts and the challenges of image analysis , 2018, European Radiology Experimental.

[32]  Fuhui Long,et al.  An anatomic transcriptional atlas of human glioblastoma , 2018, Science.

[33]  Quoc V. Le,et al.  Don't Decay the Learning Rate, Increase the Batch Size , 2017, ICLR.

[34]  Johan Pallud,et al.  Imaging practice in low-grade gliomas among European specialized centers and proposal for a minimum core of imaging , 2018, Journal of Neuro-Oncology.

[35]  K. Yeom,et al.  Radiomics in Brain Tumor: Image Assessment, Quantitative Feature Descriptors, and Machine-Learning Approaches , 2017, American Journal of Neuroradiology.

[36]  Ahmed Hosny,et al.  Artificial intelligence in radiology , 2018, Nature Reviews Cancer.

[37]  H R Jäger,et al.  Glioma imaging in Europe: A survey of 220 centres and recommendations for best clinical practice , 2018, European Radiology.

[38]  James H Thrall,et al.  Artificial Intelligence and Machine Learning in Radiology: Opportunities, Challenges, Pitfalls, and Criteria for Success. , 2018, Journal of the American College of Radiology : JACR.

[39]  Pradeep Dubey,et al.  Mixed Precision Training of Convolutional Neural Networks using Integer Operations , 2018, ICLR.

[40]  Klaus H. Maier-Hein,et al.  Automated brain extraction of multisequence MRI using artificial neural networks , 2019, Human Brain Mapping.

[41]  Tamim Niazi,et al.  Radiomics in Glioblastoma: Current Status and Challenges Facing Clinical Implementation , 2019, Front. Oncol..

[42]  Raymond Y Huang,et al.  Artificial intelligence in cancer imaging: Clinical challenges and applications , 2019, CA: a cancer journal for clinicians.

[43]  Zhiyuan Xue,et al.  Radiomics-Enhanced Multi-task Neural Network for Non-invasive Glioma Subtyping and Segmentation , 2019, RNO-AI@MICCAI.

[44]  Ho Sung Kim,et al.  Diffusion- and perfusion-weighted MRI radiomics model may predict isocitrate dehydrogenase (IDH) mutation and tumor aggressiveness in diffuse lower grade glioma , 2019, European Radiology.

[45]  F. Barkhof,et al.  Inter-rater agreement in glioma segmentations on longitudinal MRI , 2019, NeuroImage: Clinical.

[46]  Yonehiro Kanemura,et al.  Radiomics and MGMT promoter methylation for prognostication of newly diagnosed glioblastoma , 2019, Scientific Reports.

[47]  Qian Wang,et al.  Pre-operative Overall Survival Time Prediction for Glioblastoma Patients Using Deep Learning on Both Imaging Phenotype and Genotype , 2019, MICCAI.

[48]  Ahmet Gunduz,et al.  Resource Efficient 3D Convolutional Neural Networks , 2019, 2019 IEEE/CVF International Conference on Computer Vision Workshop (ICCVW).

[49]  Frank Hutter,et al.  Decoupled Weight Decay Regularization , 2017, ICLR.

[50]  Ole Solheim,et al.  MGMT Promoter Methylation Status Is Not Related to Histological or Radiological Features in IDH Wild-type Glioblastomas. , 2020, Journal of neuropathology and experimental neurology.

[51]  Seung Hong Choi,et al.  Radiomics prognostication model in glioblastoma using diffusion- and perfusion-weighted MRI , 2020, Scientific Reports.

[52]  Gereon R Fink,et al.  Radiomics in Neuro-Oncology: Basics, Workflow, and Applications. , 2020, Methods.

[53]  Jitender Saini,et al.  A Review of Radiomics and Deep Predictive Modeling in Glioma Characterization. , 2020, Academic radiology.

[54]  Pieter Wesseling,et al.  cIMPACT‐NOW update 6: new entity and diagnostic principle recommendations of the cIMPACT‐Utrecht meeting on future CNS tumor classification and grading , 2020, Brain pathology.

[55]  Bjarne Winther Kristensen,et al.  Do we really know who has an MGMT methylated glioma? Results of an international survey regarding use of MGMT analyses for glioma , 2019, Neuro-oncology practice.

[56]  Alaa Tharwat,et al.  Classification assessment methods , 2020, Applied Computing and Informatics.

[57]  Sarah Chihati,et al.  A review of recent progress in deep learning-based methods for MRI brain tumor segmentation , 2020, 2020 11th International Conference on Information and Communication Systems (ICICS).

[58]  Milan Decuyper,et al.  Automated MRI based pipeline for glioma segmentation and prediction of grade, IDH mutation and 1p19q co-deletion , 2020, 2005.11965.