title: Visualization of heterogeneity and regional grading of gliomas by multiple features using magnetic resonance-based clustered images.
abstract: Preoperative glioma grading is important for therapeutic strategies and influences prognosis. Intratumoral heterogeneity can cause an underestimation of grading because of the sampling error in biopsies. We developed a voxel-based unsupervised clustering method with multiple magnetic resonance imaging (MRI)-derived features using a self-organizing map followed by K-means. This method produced novel magnetic resonance-based clustered images (MRcIs) that enabled the visualization of glioma grades in 36 patients. The 12-class MRcIs revealed the highest classification performance for the prediction of glioma grading (area under the receiver operating characteristic curve = 0.928; 95% confidential interval = 0.920-0.936). Furthermore, we also created 12-class MRcIs in four new patients using the previous data from the 36 patients as training data and obtained tissue sections of the classes 11 and 12, which were significantly higher in high-grade gliomas (HGGs), and those of classes 4, 5 and 9, which were not significantly different between HGGs and low-grade gliomas (LGGs), according to a MRcI-based navigational system. The tissues of classes 11 and 12 showed features of malignant glioma, whereas those of classes 4, 5 and 9 showed LGGs without anaplastic features. These results suggest that the proposed voxel-based clustering method provides new insights into preoperative regional glioma grading.
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.|Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Rika
authors.initials: R
authors.lastname: Inano
authors.affiliation: Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan.|Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Oishi
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Takeharu
authors.initials: T
authors.lastname: Kunieda
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Arakawa
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kikuchi
authors.affiliation: Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan.|Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan.
authors.forename: Hidenao
authors.initials: H
authors.lastname: Fukuyama
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Miyamoto
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005910:Glioma / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D060787:Neoplasm Grading