title: Multi-Parametric MRI and Texture Analysis to Visualize Spatial Histologic Heterogeneity and Tumor Extent in Glioblastoma.
abstract: BACKGROUND
  Genetic profiling represents the future of neuro-oncology but suffers from inadequate biopsies in heterogeneous tumors like Glioblastoma (GBM). Contrast-enhanced MRI (CE-MRI) targets enhancing core (ENH) but yields adequate tumor in only ~60% of cases. Further, CE-MRI poorly localizes infiltrative tumor within surrounding non-enhancing parenchyma, or brain-around-tumor (BAT), despite the importance of characterizing this tumor segment, which universally recurs. In this study, we use multiple texture analysis and machine learning (ML) algorithms to analyze multi-parametric MRI, and produce new images indicating tumor-rich targets in GBM.
  
  
  METHODS
  We recruited primary GBM patients undergoing image-guided biopsies and acquired pre-operative MRI: CE-MRI, Dynamic-Susceptibility-weighted-Contrast-enhanced-MRI, and Diffusion Tensor Imaging. Following image coregistration and region of interest placement at biopsy locations, we compared MRI metrics and regional texture with histologic diagnoses of high- vs low-tumor content (≥80% vs <80% tumor nuclei) for corresponding samples. In a training set, we used three texture analysis algorithms and three ML methods to identify MRI-texture features that optimized model accuracy to distinguish tumor content. We confirmed model accuracy in a separate validation set.
  
  
  RESULTS
  We collected 82 biopsies from 18 GBMs throughout ENH and BAT. The MRI-based model achieved 85% cross-validated accuracy to diagnose high- vs low-tumor in the training set (60 biopsies, 11 patients). The model achieved 81.8% accuracy in the validation set (22 biopsies, 7 patients).
  
  
  CONCLUSIONS
  Multi-parametric MRI and texture analysis can help characterize and visualize GBM's spatial histologic heterogeneity to identify regional tumor-rich biopsy targets.
authors.affiliation: Department of Radiology, Mayo Clinic, Phoenix, Arizona, United States of America.|Department of Radiology, Barrow Neurological Institute, Phoenix, Arizona, United States of America.
authors.forename: Leland S
authors.initials: LS
authors.lastname: Hu
authors.affiliation: School of Computing, Informatics and Decision Systems Engineering, Arizona State University, Tempe, Arizona, United States of America.
authors.forename: Shuluo
authors.initials: S
authors.lastname: Ning
authors.affiliation: Department of Pathology, Barrow Neurological Institute, Phoenix, Arizona, United States of America.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Eschbacher
authors.affiliation: School of Computing, Informatics and Decision Systems Engineering, Arizona State University, Tempe, Arizona, United States of America.
authors.forename: Nathan
authors.initials: N
authors.lastname: Gaw
authors.affiliation: Department of Biostatistics, Mayo Clinic, Phoenix, Arizona, United States of America.
authors.forename: Amylou C
authors.initials: AC
authors.lastname: Dueck
authors.affiliation: Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, United States of America.
authors.forename: Kris A
authors.initials: KA
authors.lastname: Smith
authors.affiliation: Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, United States of America.
authors.forename: Peter
authors.initials: P
authors.lastname: Nakaji
authors.affiliation: School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona, United States of America.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Plasencia
authors.affiliation: Department of Radiology, Mayo Clinic, Phoenix, Arizona, United States of America.
authors.forename: Sara
authors.initials: S
authors.lastname: Ranjbar
authors.affiliation: Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Price
authors.affiliation: Department of Cancer and Cell Biology, Translational Genomics Research Institute, Phoenix, Arizona, United States of America.
authors.forename: Nhan
authors.initials: N
authors.lastname: Tran
authors.affiliation: Department of Cancer and Cell Biology, Mayo Clinic, Scottsdale, AZ, United States of America.
authors.forename: Joseph
authors.initials: J
authors.lastname: Loftus
authors.affiliation: Department of Pathology, Mayo Clinic, Rochester, Minnesota, United States of America.
authors.forename: Robert
authors.initials: R
authors.lastname: Jenkins
authors.affiliation: Department of Neuro-oncology, Mayo Clinic, Rochester, Minnesota, United States of America.
authors.forename: Brian P
authors.initials: BP
authors.lastname: O'Neill
authors.affiliation: Department of Pharmacology, University of Minnesota, Minneapolis, Minnesota, United States of America.
authors.forename: William
authors.initials: W
authors.lastname: Elmquist
authors.affiliation: Department of Radiology, Barrow Neurological Institute, Phoenix, Arizona, United States of America.
authors.forename: Leslie C
authors.initials: LC
authors.lastname: Baxter
authors.affiliation: School of Computing, Informatics and Decision Systems Engineering, Arizona State University, Tempe, Arizona, United States of America.
authors.forename: Fei
authors.initials: F
authors.lastname: Gao
authors.affiliation: School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona, United States of America.
authors.forename: David
authors.initials: D
authors.lastname: Frakes
authors.affiliation: Department of Radiology, Barrow Neurological Institute, Phoenix, Arizona, United States of America.
authors.forename: John P
authors.initials: JP
authors.lastname: Karis
authors.affiliation: Department of Radiology, Mayo Clinic, Phoenix, Arizona, United States of America.
authors.forename: Christine
authors.initials: C
authors.lastname: Zwart
authors.affiliation: Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States of America.
authors.forename: Kristin R
authors.initials: KR
authors.lastname: Swanson
authors.affiliation: Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, United States of America.
authors.forename: Jann
authors.initials: J
authors.lastname: Sarkaria
authors.affiliation: Department of Radiology, Mayo Clinic, Phoenix, Arizona, United States of America.|School of Computing, Informatics and Decision Systems Engineering, Arizona State University, Tempe, Arizona, United States of America.
authors.forename: Teresa
authors.initials: T
authors.lastname: Wu
authors.affiliation: Department of Radiology, Mayo Clinic, Phoenix, Arizona, United States of America.
authors.forename: J Ross
authors.initials: JR
authors.lastname: Mitchell
authors.affiliation: Department of Radiology, Mayo Clinic, Phoenix, Arizona, United States of America.|School of Computing, Informatics and Decision Systems Engineering, Arizona State University, Tempe, Arizona, United States of America.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
mesh_terms: D000465:Algorithms; D003287:Contrast Media / Q000008:administration & dosage; D056324:Diffusion Tensor Imaging / Q000379:methods; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D061705:Image-Guided Biopsy / Q000379:methods*; D000069550:Machine Learning; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011859:Radiography
chemical_list: D003287:Contrast Media